This literature review is devoted to the most common hereditary disease of the retina, called Stargardt disease. The work provides information on the epidemiology, molecular genetics, and pathophysiology of this disease. Clinical forms of Stargardt disease are described in details. Special attention is paid to a multimodal approach using modern visualization methods, such as retinal optical coherence tomography, autofluorescence study, which allow differential diagnostics with diseases such as retinal pattern dystrophies, autosomal dominant Stargardt-like macular dystrophies STGD3 and STGD4, neuronal ceroid lipofuscinosis. The article presents information on potential treatment methods for patients with Stargardt disease aimed at either reducing lipofuscin accumulation in retinal pigment epithelium cells or delivering the normal ABCA4 gene to the eye.

Artificial intelligence (AI) is becoming an integral part of modern medical technologies, especially in the field of disease diagnostics.

In recent years, its application in ophthalmology has become broader, and it affects an increasing number of nosologies.

This review article covers the issues of AI terminology, historical aspects of the use of AI in medicine in general and in ophthalmology in particular, and highlights modern achievements and scientific developments in this field.

The future of AI in ophthalmology and the prospects for the development are discussed. Ophthalmologists, researchers, and artificial intelligence experts are the target audience for this article.

Thus, the study demonstrated that both styes and chalazions are 2.1 times more likely to recur than non-recurring cases. Stye

and chalazion were most frequently detected in patients with a history of cosmetic procedures in the periorbital area, followed in descending order by patients with skin diseases and complicated somatic conditions, primarily gastrointestinal diseases. Data analysis is aimed for studying the influence of risk factors on the occurrence of styes revealed clinically significant differences: styes (an acute inflammatory process of the meibomian glands) occur 19.2 % more frequently in patients with a history of cosmetic procedures in the periorbital area, primarily in patients who had eyelash extensions (the difference in rates in this subgroup was 20.3 %). Stye provoked by primary cosmetic procedures is often not recurrent, while skin diseases in patients with stye increase the recurrence rate by 22.4 %, and an aggravated somatic status, in particular gastrointestinal diseases, by 65.2 % at p < 0.001. The data obtained through the use of artificial intelligence programs in studying the influence of the significance of risk factors for chalazion development showed that, according to the SHAP values in the LightGBM model, the following factors had the greatest influence on the development of recurrent chalazion (in descending order): blepharoplasty (1.23), gastrointestinal diseases (0.89), autoimmune diseases (0.52), botulinum toxin (0.48), and a history of allergic reactions (0.25). The obtained data can allow routing the patient for additional examination and treatment by specialists, which will increase the effectiveness of the therapy.

Purpose. Analysis of short-term clinical and functional results of implantation of a new refractive IOL with extended depth of focus.

Materials and methods. The study included 20 patients (31 eyes) after bilateral (11 patients) or monolateral (9 patients) implantation of the TECNIS PureSee® IOL, model DEN00V (Johnson and Jonson, USA) with an average follow-up period of 2.6 ± 0.5 (2–4) months. In all cases, IOL implantation was preceded by cataract phacoemulsification or clear lens removal. Women accounted for 65 % (n = 13), men — 35 % (n = 7). 

Results. There was a significant (p < 0.05) increase in UCNVA from 0.21 ± 0.03 to 0.65 ± 0.11, UCIVA from 0.24 ± 0.05 to 0.89 ± 0.13, UCDVA from 0.27 ± 0.05 to 0.96 ± 0.15, BCIVA from 0.52 ± 0.08 to .97 ± 0.19 and BCDVA from 0.67 ± 0.15 to 1.0 ± 0.14 before surgery and after 1 month of observations, respectively. The BCNVA increased from 0.54 ± 0.09 to 0.79 ± 0.14 (differences are significant at the trend level, 0.05 < p < 1.0). After implantation of the TECNIS PureSee® IOL, a decrease in the spherical equivalent of refraction was shown from -2.5±1.2 in the preoperative period to-0.14 ± 0.69 during the follow-up period of 1 month. In 2 out of 20 patients (10 %), permanent or periodic side optical phenomena were detected, of which 1 patient (5 %) had glare and 1 (5 %) had halo. The patients did not complain on difficulties in the night driving. Only one of 20 patients (5 %) required a reading glasses correction. All 20 patients rated the result of the operation as “excellent” and would recommend the implantation of this IOL to their friends and relatives. 

Conclusion. The paper presents the first experience in the Russian Federation of implantation of refractive with extended depth of focus in 20 patients (31 eyes). The results obtained demonstrate the high efficiency of this IOL for vision correction at all distances and the low frequency of side optical phenomena, which led to high patient satisfaction. To expand the indications for implantation of the studied IOL, further comparative studies with other models of monoand multifocal IOLs, as well as EDOF IOLs, are necessary.

Objectives: to evaluate the prognostic significance of early postoperative inflammatory response parameters, namely visible aqueous

humor opalescence and ciliary body thickness increase, for the effectiveness of transscleral laser cyclothermotherapy (TLCTT) in patients with primary open-angle glaucoma. 

Patients and methods. A retrospective analysis included 33 patients (22 men, 11 women; mean age 72.4 years) with uncontrolled primary open-angle glaucoma despite maximally tolerated hypotensive therapy. TLCTT was performed under local anesthesia with up to 16 applications delivered in the mode of 0.5 W for 20 s. Optical coherence tomography (CASIA2, Tomey, Japan) was used to assess ciliary body thickness before surgery and on postoperative day 1. Presence of aqueous humor opalescence was also recorded on day 1. Intraocular pressure (IOP) was measured by Maklakov tonometry, and topical regimen was documented preoperatively and at 1, 3, 6, and 12 months. Treatment success was defined as IOP reduction ≥ 20 % starting from 1 month.

Results. Mean IOP reduction at 12 months was 8.8 ± 3.9 mmHg, corresponding to 23.8 % (p < 0.001). Treatment success was achieved in 24 patients (72.7 %). Visible aqueous humor opalescence on day 1 was observed in 24 patients (72.7 %) and correlated positively with greater IOP reduction (p = 0.008, r = 0.72). Ciliary body thickness increased significantly on day 1 postoperatively (p < 0.0001). The dynamics of thickness increase showed a strong positive correlation with IOP reduction (r = 0.86, p < 0.05). 

Conclusion. Early postoperative signs of intraocular inflammation and ciliary body edema can serve as reliable predictors of TLCTT effectiveness. Visible aqueous humor opalescence and increased ciliary body thickness on day 1 are associated with higher likelihood of achieving a sustained hypotensive effect within 1 month. These parameters may be recommended for early prediction of treatment outcomes in patients undergoing TLCTT for primary open-angle glaucoma.

Currently, implantation of toric IOLs is the main correction method of regular corneal astigmatism in patients with cataracts. However,

weakness of the lens zonules and lack of capsular support are negative factors for the use of toric IOLs. The question of the possibility of toric IOL implantation in these clinical situations remains open, especially in the state of avitria. 

Purpose: to evaluate the safety and efficacy of toric IOL sclerocorneal fixation in the absence of capsular support and avitria status. Materials and methods: a prospective study of the results of a toric IOL sclerocorneal fixation (n = 12) was conducted. All patients underwent a combined surgery, including subtotal vitrectomy and a toric IOL sclerocorneal fixation of. In addition to the standard ophthalmologic examination, ultrasound B-scanning (VuMax HD Sonomed Inc. USA), keratotopography (Pentacam HR, Oculus, Germany), optical coherence tomography (RTVue XR Avanti Optovue, USA) were performed; the features of the surgical course, duration of surgery, and the presence of intraand postoperative complications were analyzed. The follow-up period was 12 months after surgery. 

Results. Average surgical time was 57 minutes [44, 76]. No significant complications were observed during surgery. According to ultrasound biomicroscopy data 12 months after surgery, a clinically insignificant tilt of the IOL (from 5 to 7 degrees) was detected in five cases. Optical coherence tomography did not reveal any signs of macular edema in any case. There were no cases of flange cutting and externalization, or manifestations of infectious complications. The values of uncorrected distance visual acuity before surgery were 0.05 [0.01; 0.12], after surgery — 0.32 [0.20; 0.60], the best corrected visual acuity before surgery was on average 0.12 [0.05; 0.40], after surgery — 0.40 [0.35; 0.50]. 

Conclusion. Combined surgery, including vitrectomy and sclerocorneal fixation of a toric IOL, is an effective and safe method for correcting aphakia and corneal astigmatism in cases where capsular support is absent.

Purpose. To optimize a-constants for intraocular lenses (IOL) on the Clareon® (Alcon, USA) platform. 

Material and methods. The study included 206 patients (206 eyes) divided into 4 groups depending on IOL implanted model: the 1^st — SY60WF (n = 71); the 2^nd — Clareon Toric CNW0T2-9 (n = 76); the 3^rd — Clareon PanOptix CNWTT0-Т6 (n = 32); the 4^th — Clareon Vivity CNWET0-Т6 (n = 27). Optical biometry was performed by IOL-Master 700 (Carl Zeiss, Germany). For toric IOL calculation keratotopography by CASIA Corneal/Anterior Segment OCT SS-1000 (Tomey, Japan) was performed. A month after phacoemulsification spherical equivalent of refraction was evaluated. Mean IOL calculation error (ME) was used to calculation accuracy assessment. A-constant optimization performed by ME zeroing. 

Results. ME was 0.32 ± 0.42 D for Clareon SY60WF, 0.31 ± 0.36 D for Clareon Toric CNW0T2-9, 0.38 ± 0.34 D for Clareon PanOptix CNWTT0-Т6 and 0.10 ± 0.34 D for Clareon Vivity CNWET0-Т6. ME zeroing allows to define real a-constants for IOLs: 119.38 for Clareon SY60WF, 119.46 for Clareon Toric CNW0T2-9, 119.54 for Clareon PanOptix CNWTT0-Т6 and 119.30 for Clareon Vivity CNWET0-Т6. 

Conclusion. Using of proposed a-constants for IOLs on Clareon® platform could help with target refraction achievement and to avoid a hyperopic refraction shift.

Introduction. Congenital blepharoptosis represents a significant ophthalmoplastic pathology that substantially impacts the quality of life for patients and their families. Epidemiologically, blepharoptosis frequently coexists with other pathological conditions, predominantly of neurological origin. The presence of concomitant pathologies may considerably influence both surgical strategy and postoperative results.

Objective. To evaluate the impact of somatic pathology on the severity of congenital blepharoptosis in pediatric patients and on surgical outcomes. 

Materials and methods. A retrospective analysis was conducted on 113 pediatric patient records who underwent surgical correction of congenital blepharoptosis of varying severity. Patients were divided into two groups: somatically healthy (n = 90) and with concomitant somatic pathology (n = 23), including congenital cardiovascular, renal, or central nervous system anomalies. Criteria for preoperative surgical planning included: unilateral or bilateral ptosis, degree of ptosis, levator muscle function (LMF), margin-reflex distance 1 (MRD1), palpebral fissure width at the pupillary center, lateral and medial limbus, presence of lagophthalmos, height and presence of eyelid crease, and involvement of accessory muscles (e.g., brow mobility). Surgical interventions comprised levator resection and superior tarsal muscle resection. Postoperative follow-up was performed inpatient on days 1, 3, and 7, and outpatient at 1, 3, 6, and 12 months. 

Results. In the somatically healthy group, unilateral blepharoptosis predominated, whereas bilateral involvement was more common in the group with somatic pathologies. Statistical analysis revealed a significant correlation between bilateral blepharoptosis and the presence of somatic comorbidities (p = 0.025). Analysis of ptosis severity noted significant differences: grade 3 ptosis was observed in 51.43 % of the second group compared to 28.07 % in the first. Concomitant ophthalmic conditions were distributed as follows: amblyopia (28.89 % in group I and 39.13 % in group II), astigmatism (34.44 % and 47.83 %, respectively), and strabismus (esoor exotropia) in 20.00 % and 17.39 %. The operative time was notably longer in group II: average levator resection duration was 53.7 minutes versus

36.2 minutes in group I, with ICU stay averaging 23.6 minutes versus 16.2 minutes. Unsatisfactory outcomes necessitating reoperation were recorded in 23.33% of group I and 30.43% of group II, with no cases of persistent lagophthalmos. 

Conclusion. The presence of concomitant somatic pathology in pediatric patients with congenital blepharoptosis necessitates meticulous preoperative evaluation in a multidisciplinary hospital setting, with a high level of anesthetic support to optimize surgical planning and outcomes.

Relevance. Secondary silicone-induced glaucoma (SIG) is one of the complications of prolonged tamponade of the vitreous cavity with silicone oil. Timely detection of early signs of silicone oil emulsification is a significant diagnostic tool for an ophthalmologist. 

Methods. This article represents a comparison of instrumental methods of patient’s examination aimed to identify signs of emulsification, reveals the strengths and weaknesses of various methods, formulates and illustrates signs indicating an active emulsification process in the eye, and analyzes the possible relationship between instrumental findings and clinical data. 

Results. Ultrasound biomicroscopy has become the most universal among instrumental examination

Methods. Diagnostic capabilities of optical coherence tomography in the context of detecting a silicone oil emulsion are limited, applicable only to the posterior segment of the eye and only possible in conditions of transparent optical media. The most informative signs indicating a high risk of SIG are hyperechoicity of the structures of the ciliary apparatus (the flat part and its processes) and the angle of the anterior chamber (trabecular apparatus, Schlemm canal), as well as “ghost images”. Hyperoleon is sensitive, but probably a late sign of emulsification. When conducting research, the natural hyperechogenicity of the pigment leaf of the iris should be taken into account. Hyperechoic inclusions in the anterior chamber of the eye are not directly related to the risk of CIG, however, they indicate the emulsification process in general. 

Conclusion. Further investigation of methods for early detection of silicone oil emulsification will optimize patient management and reduce the incidence of secondary glaucoma.

Objective: to present corneal morphological changes in patients with initial keratoconus during 12-month follow-up period after simultaneous transepithelial photorefractive keratectomy with accelerated ultraviolet collagen crosslinking.

 Patients and methods. The study included 30 patients/eyes aged 18–45 years with progressive stage 1 keratoconus, who underwent laser scanning in vivo confocal microscopy before and after treatment to measure the total, average, minimum and maximum lengths of corneal nerve fibres, as well as the sub-basal nerve plexus density; corneal optical coherence tomography with measurement of the demarcation line depth; Scheimpflug densitometry of the anterior-central layers of corneal stroma at 0–2 and 2–6-mm zones. The examinations were performed 1, 6 and 12 months after surgery. 

Results. Morphological changes observed by laser scanning in vivo confocal microscopy located in the anterior and middle stroma within 300 μm depth and were temporary: at 1 month — epitheliopathy, subepithelial fibroplasia, honeycomb-type lacunar edema and a sharp decrease in sub-basal nerve plexus density; at 6 months — partial regeneration of the keratocytes and sub-basal nerve plexus, reduction of the lacunar edema; at 12 months — nealrly complete restoration of corneal cellular structure and sub-basal innervation (sub-basal nerve plexus density — 80.5 % of preoperative data, total length of nerve fibres — 82 %). According to Scheimpflug densitometry, the highest values of corneal optical density was detected at 1 month after surgery and subsequently returned to baseline at 12 months, indicating reducing of postoperative corneal haze. According to anterior segment optical coherence tomography, the demarcation line depth was 198.5 (179.25; 214.5) μm visualized at 1 month postoperatively. 

Conclusion. Simultaneous transepithelial photorefractive keratectomy with accelerated corneal crosslinking can be considered as a safe and effective approach to managing initial keratoconus, that ensures morphological restoration of the cornea and minimal risk of severe fibroblastic complications during one-year follow-up period. Further research is needed to assess the long-term stability of the results.

The duration of endoillumination is considered a potential risk factor for phototoxic retinal damage during vitreoretinal surgeries. Despite the widespread use of modern lighting systems, clinical data on the effect of endoillumination duration on functional outcomes remain limited. 

Objective: to evaluate the impact of endoillumination duration on functional outcomes and the safety of vitreoretinal surgery. 

Patients and methods. The study included patients who underwent vitreoretinal surgeries for macular holes (n = 31), retinal detachments (n = 48), and epiretinal membranes (n = 25). The duration of endoillumination, initial and postoperative bestcorrected visual acuity (BCVA), type of tamponade, and features of the surgical technique were assessed. Statistical analysis involved multivariate regression models to identify determinants of functional outcomes. 

Results. The duration of endoillumination did not have a statistically significant effect on BCVA at 12 months after surgery (p > 0.05). Anatomical success was achieved in all cases. Functional outcomes were significantly influenced by initial visual acuity (in the macular hole group), type of tamponade, and performance of combined surgery with phacoemulsification (in the retinal detachment group) (p < 0.05). No statistically significant factors were identified in the epiretinal membrane group. 

Conclusion. The obtained results indicate that the duration of endoillumination does not significantly affect the functional outcomes of vitreoretinal surgery, while the primary role remains with the initial anatomical and functional characteristics of the eye and the features of the surgical technique.

The international experiment SIRIUS-23 studied the effect of long-term isolation in a closed space (hermetic object — artificial station), simulating an interplanetary flight with accompanying stress factors, on the bioelectrical activity of the retina.

The aim of the study was to evaluate changes in the different types of electroretinogram (ERG), and in visual evoked cortical potentials (VEP) in the participants of the 12-month experiment. Changes in ocular blood flow were also assessed using Doppler research

Methods. All diagnostic examinations were conducted before and during the week after the crew exited isolation (conditional “landing”). The results indicate the general stability of the most studied parameters after the end of isolation. A slight decrease in the amplitude of flicker ERG (F-ERG) to 30 and 12 Hz flickers and P50 and N95 components of transient pattern ERG (PERG) with characteristic changes in peak latency was revealed, which indicate a mild dysfunction of retinal ganglion cells and their axons without organic damage to the visual pathways. A positive trend towards an increase in the amplitude of the photopic negative response (PhNR) to a medium-strength stimulus and the amplitude of the P100 component of VEP to a pattern-reversal to a pattern-reversal chessboard stimuli after the crew exited isolation was found. A statistically significant increase in the peripheral resistance index and pulsatility index in the ophthalmic artery, central retinal artery and lateral posterior short ciliary arteries was recorded, which may indicate a change in vascular tone in the retinal and choroidal circulation system of the eye after a 12-month experiment.

A review of the literature data indicates the need for additional research to improve the effectiveness of barley and chalazion treatment, in particular to determine objective indicators of barley transition to chalazion based on instrumental studies, and to study the relationship of the above pathological processes with concomitant pathologies, in particular, acute respiratory diseases and dry eye syndrome. The conducted study allowed us to develop an algorithm for differential diagnosis of barley and chalazion: barley is an acute inflammatory process of the sebaceous glands of Zeiss (external) and meibomian (internal), in 55.2 % of cases it develops against the background of hypothermia and/or acute respiratory viral infections, is stopped by local use of antibiotics and corticosteroids in 65.5 % of cases during an observation period of 7–14 days, in 34.5 % of cases it passes into the stage of chronic inflammation — secondary chalazion; A secondary chalazion is the transition of an acute inflammatory process to a chronic one over an observation period of 14 to 30 days (capsule formation), accompanied by an increase in its density and blood flow velocity, as determined by ultrasound. A chalazion is detected three times less frequently than a primary chalazion due to a disruption of the secretion of the meibomian glands without signs of acute inflammation. Correlation analysis data showed that the longer the chalazion persists, the denser its capsule becomes and the more severe the impairment of blood circulation in the area. The data obtained during the study can serve as a basis for developing a conceptual understanding of the etiopathogenesis of styes and chalazions in practicing physicians. This, in turn, will facilitate the appointment of timely and adequate treatment methods, including the consistent use of local drug therapy, intracapsular glucocorticoid injections, surgical removal of the chalazion, as well as the appointment of preventive treatment in the form of eyelid hygiene and other physiotherapeutic procedures at the stage of stopping this pathological process.

The manifestation of herpetic keratitis is influenced by a variety of pathological factors. Coronavirus infection is both a precipitating and triggering factor for ophthalmic herpes, both in the acute phase of the disease and in post-COVID syndrome. Given the combined attack on the immune system by the coronavirus itself, herpes viruses, and iatrogenic immunosuppression, is difficult to overestimate the pathological role of secondary bacterial infection. The aim of this study is a retrospective analysis the results of microbial associations in conjunctival and nasopharyngeal swabs in patients with complicated ophthalmic herpes following coronavirus pneumonia. 

Material and methods. The retrospective analysis included 11 patients with various forms of herpetic keratitis with ulceration (recurrent/sluggish flow), which developed late after severe coronavirus pneumonia. All patients underwent a standard ophthalmic examination and were questioned about the presence of trigger factors and comorbid conditions. Microbiological samples from the conjunctiva and nasopharynx were cultured on solid nutrient media. Colony growth was quantified in colony-forming units (CFU/ml) per 1.0 ml of biological material using standard grading methods. Identified pathogens were tested for sensitivity to the main groups of antibacterial drugs using the disk method. Results: In only one case, conjunctival culture yielded two pathogenic cultures — Staphylococcus aureus and Moraxella catarrhalis — at 104–106 CFU/ml. The results of nasopharyngeal culture on nutrient media turned out to be informative with respect to the dominant pathogens. Among the nasopharyngeal culture results (25 cultures), the leading ones were Staphylococcus aureus (10 cases, 40 %) and Streptococcus pneumoniae (7 cases, 28 %). Less frequently, the growth of cultures of such pathogens as Klebsiella pneumoniae (4 cases, 16 %), Escherichia coli (8 %), Moraxella catarrhalis and Hemophilus influenzae (4 % each) was determined. When determining the sensitivity to groups of antibiotics, the microflora showed high sensitivity to fluoroquinolones (15 samples, 60 % of cases), mainly moderate sensitivity was determined to macrolides and aminoglycosides (15 and 14 samples, respectively). Moderate sensitivity was determined to penicillins (19 samples), and the highest proportion of resistance was found to cephalosporins. 

Conclusion. The high sensitivity of the isolated microflora to fluoroquinolones indicates their use in the treatment of complicated forms of herpetic keratitis with activation of polybacterial flora. One of the possible drugs of choice is besifloxacin, which is not used systemically and has minimal risks of potential resistance of microbial associations to it. A comprehensive treatment approach, including thorough laboratory testing and consultation with related specialists (otolaryngologist and immunologist), is crucial for achieving recovery in the development of protracted forms of ophthalmic herpes associated with chronic inflammatory diseases of the nasopharynx.

Purpose: to investigate the nature, intensity and frequency of the main subjective manifestations of digital accommodative asthenopia online, to determine their relationship with basic ophthalmoergonomic indicators.

Design and research methods. The online screening study was conducted on 1310 students (average age 21.5 ± 0.1 years; 75.3 % of respondents were female, 24.7 % were male). The psychometric scale used contained 25 items from 5 questions reflecting the main symptoms of accommodative asthenopia, as well as ophthalmoergonomic questions.

Results and discussion. The average work experience with mobile screen devices (MSD) was 10.29 ± 0.1 years. At the same time, the average daily duration, as well as the one-time duration of using the digital television, varied widely up to 1 hour and more than 6 hours. The average distance from the eyes to the screen was 36.0 ± 0.5 cm (from 5 to 120 cm). Complaints of varying intensity and nature were expressed by 74.6 % of respondents, with the maximum rating of “constantly” and “very strong” in the percentage of respondents: difficulty focusing at a distance (5.6 % and 5.7 % of respondents, respectively), eye strain when looking at the screen — 2.3 % and 2.7 %, fogginess and blurriness — 1.7 % and 1.2 % of respondents. There were no significant correlation between the length of use of devices and complaints of accommodation problems among the respondents surveyed. A positive weak but significant relationship was found between the indicators “duration of using the digital optics and digital electronic devices per session” and “duration of using the digital optics and digital electronic devices during the day” with complaints of strain when fixing the gaze on the screen, as well as with blurred vision and problems focusing into the distance. The absence of a significant correlation between the length of use of devices and accommodative complaints may indicate the inclusion of some kind of stable, reliable mechanisms of accommodation compensation by the type of long-term adaptation, masking the subjective manifestations of the digital accommodative asthenopia. On the contrary, complaints of accommodative asthenopia associated with the duration of use per session or during the day reflect urgent, “emergency” compensation mechanisms and are manifested more clearly in the form of corresponding complaints of visual discomfort. 

Conclusion. A conclusion is made about the adequacy and effectiveness of the methodological approach using a multidimensional scale in on-line mode for analyzing the subjective manifestations of digital accommodative asthenopia. The data confirm the important role of ophthalmoergonomic factors in the formation of digital accommodative asthenopia in information technology users.

Visual impairment and especially pronounced decrease in visual acuity without correction due to senile cataract and primary glaucoma significantly reduces the motor activity of elderly patients and can contribute to the development of sarcopenic obesity. However, the effect of visual deficit on the prevalence of sarcopenic obesity in the named age was not carried out. The purpose of the study was to study visual impairment as a risk factor for sarcopenic obesity among the elderly patients. At the S.N. Fedorov National medical research center “MNTK Eye Microsurgery” 289 patients aged 60–74 years with cataract and sarcopenic obesity and 294 patients aged 60–74 years with primary glaucoma and sarcopenic obesity were examined. Cataract was diagnosed according to the criteria presented in the Clinical Guidelines for Senile Cataract, and primary glaucoma — in the National Glaucoma Guidelines. Sarcopenic obesity was identified based on the criteria of decreased muscle strength, decreased muscle mass, and increased body mass index, taking into account the recommendations proposed by the European Working Group on Sarcopenia in Older People (EWGSOP2, 2018). The maximum prevalence of sarcopenic obesity among elderly patients with cataract was established by uncorrected visual acuity of 0.20–0.30, which amounted to 58.1 ± 3.7 % among all representatives of this group. A high prevalence of sarcopenic obesity was also observed with uncorrected visual acuity of 0.31–0.40 — 26.0 ± 1.9 % of cases. With other parameters of uncorrected visual acuity in cataract, sarcopenic obesity was significantly less common (p < 0.001). A similar pattern was found in visual impairment due to primary glaucoma in patients of the same age. The correlation between uncorrected visual acuity and the prevalence of sarcopenic obesity was strong both in cataract (r = -0.764, p < 0.001) and in primary glaucoma (r = -0.712; p < 0.001). The obtained results allow us to consider visual impairment as a significant risk factor for sarcopenic obesity in the elderly with cataract and primary glaucoma, and early screening of these diseases will help reduce sarcopenic obesity.

Changes in pupillary reflex parameters depend on the state of the visual analyzer and nervous system. Pupillometry is an accurate and

easy-to-use method for diagnosing pupillary reflex, which can detect pathology at the preclinical level. An analysis of literary sources showed that scientists around the world are interested in changes in pupil parameters in patients with various ophthalmological pathologies: pigment retinitis, diabetic retinopathy, age-related macular degeneration, glaucoma, central retinal vein occlusion, optic neuritis, and ischemic optic neuropathy. Determined that when the ganglion complex and nerve fibers of the retina and the optic nerve head are affected, pupillary reaction dysfunction occurs in various ophthalmological diseases. The severity of changes in pupillometry parameters is comparable to the severity of damage to the retina and optic nerve, which is confirmed by optical coherence tomography protocols. Scientists also took into account the fact that rods, cones, and ganglion cells have different activation thresholds and differ in reaction properties, so to assess their function, they proposed using stimuli of different colors and different intensities, which contributed to the emergence of such a diagnostic method as chromatic pupillometry. Color stimuli were also used to study pupillary response in optic nerve diseases; scientists noted differences in pupillary reflex parameters when exposed to red or blue stimuli. Studying the possibility of using pupillometry as an effective screening method in diagnosing ophthalmological diseases is a promising scientific direction.

Purpose: to evaluate the differences in the structural parameters of the optic nerve head (ONH) and peripapillary region in patients with high myopia in comparison with patients without refractive errors. 

Patients and methods. The first group included patients with an equivalent refractive error ≥ -6.00 diopters and an eye length ≥ 26.00 mm (74 eyes). The second group consisted of patients with a refraction of -0.5 diopters — +1.25 diopters and an eye length of 22.50–24.20 mm (32 eyes). Axial length measurements were carried out using an IOLMaster 700 (Zeiss, Germany). Optical coherence tomography (OCT) of the ONH was performed with SOLIX (Optovue, USA) using the AngioAnalytics software. For statistical analysis of the results, the nonparametric Mann–Whitney’s test and Spearman’s rank correlation coefficient were used. 

Results. In the first group, the cup-to-disc vertical ratio (VCDR) values were lower (0.38 (0.14–0.51), p < 0.05), and there was a decrease in the average thickness of the retinal nerve fiber layer (RNFL) (86.00 (80.00–94.00), p < 0.01), as well as RNFL thickness measured in individual sectors (p < 0.01), compared with the second group. The thickness of the RNFL in the temporal quadrant, in the inferior sector of the temporal quadrant (TI), on the contrary, was greater (71.00 (58.05–87.25), p < 0.01). All radial peripapillary capillary vessel density (RPC VD) values were not significantly different between groups (p > 0.05). The highest RPC VD is in the upper sector of the temporal quadrant (TS) (56.65 (51.72–59.47)). The density of all vessels (VD) was significantly lower in patients with high myopia, except for the zones corresponding to the temporal quadrant and the inside disc zone (ID) (p > 0.05). 

Conclusion. Significant differences were revealed between the groups in VCDR, RNFL thickness and VD in all areas, except the temporal quadrant. A decrease in the thickness of the RNFL in the temporal quadrant, TI, as well as a decrease in the thickness of the RPC VD in the ID zone and the temporal quadrant, TS, can be the most indicative parameters for diagnosing optic nerve pathology in patients with high myopia, not associated with axial elongation of the eyeball.

Introduction. Progressive myopia remains a serious medical and social problem that requires effective methods of its stabilization.

A promising non-invasive approach is glasses with a defocused DIMS design that slow down the axial growth of the eye. Comparative studies of evidence-based methods allow selection of optimal control strategies for different patient groups. The present work is part of a large project aimed at evaluating such methods.

 Purpose: to study the effect of DIMS glasses on myopia progression in children and adolescents by axial length (AL) and spheroequivalent (SE) scores over 12 months. 

Patients and methods. The study included 63 children 7–14 years old with mild to moderate myopia (-0.50 D to -6.00 D). Patients independently chose the method of correction: transfocal glasses, orthokeratology or soft bifocal lenses. The study group consisted of those who chose glasses with DIMS. AL and SE were measured at baseline and 12 months. Myopia was stratified. 

Results. Over the year, the average increase in AL was

0.16 ± 0.06 mm, SE — 0.31 ± 0.08 D. With mild myopia, a moderate positive correlation was found between AL and SE (r = +0.372, p = 0.0276); with a moderate degree — no. Refusal of points (28.6%) was more often associated with the transition to MCL with defocus or OCL. 

Conclusions. Glasses with DIMS lenses were effective in slowing the progression of myopia. Patients with mild myopia showed a moderate positive correlation between axial length and spheroequivalent, in contrast to the group with moderate myopia, which may indicate differences in the mechanisms of progression. Refusal of glasses was more often associated with the transition to alternative methods of correction (MCL with defocus or OCL), emphasizing the importance of an individual approach and the possibility of choice to increase adherence to therapy.

Salzmann nodular degeneration (SND) is a rare, non-inflammatory, slowly progressive degenerative corneal disease characterized by the formation of superficial bluish-white nodules measuring 1–3 mm in diameter. Although the condition was first described more than 80 years ago, many aspects of its etiopathogenesis, risk factors, epidemiology, and clinical course remain insufficiently studied. SND typically manifests in the fifth or sixth decade of life, whereas onset in childhood or adolescence is considerably less common and may present diagnostic challenges, particularly in patients with long-standing recurrent epithelial corneal disorders. 

Purpose: to present a clinical case of Salzmann nodular degeneration in an adolescent patient and to analyze the features of its clinical course and management. 

Patient and methods. A clinical case of a 16-year-old female patient with bilateral anterior segment involvement is described. A comprehensive ophthalmologic examination was performed, including assessment of visual acuity, slit-lamp biomicroscopy, keratometry, autorefractometry, and optical coherence tomography. Treatment included superficial keratectomy followed by postoperative medical therapy aimed at controlling inflammatory changes and promoting corneal epithelial recovery, as well as use of a bandage soft contact lens combined with keratoprotective therapy during the postoperative period.

Results. At initial examination, typical SND findings were identified, including subepithelial and superficial stromal nodular opacities with epithelial elevation. The combined surgical and conservative treatment resulted in complete corneal re-epithelialization, reduction in the severity of corneal opacities, improvement in visual acuity, and stabilization of the ocular surface. During a 9-month follow-up period, no signs of disease progression were observed. 

Conclusion. The presented clinical case illustrates a rare manifestation of Salzmann nodular degeneration in the adolescent patients and highlights the importance of timely diagnosis and a comprehensive treatment approach to achieve favorable clinical outcomes and stabilization of visual function.

A clinical case of exudative retinal detachment after trabeculectomy for secondary glaucoma with Sturge-Weber syndrome is presented. A 50-year-old female patient with Sturge-Weber syndrome sought help for secondary glaucoma with elevated intraocular pressure on maximum drug hypotensive therapy. According to these indications, she was offered trabeculectomy with posterior trepanation of the sclera. Surgical treatment was without intraoperative complications. However, in the early postoperative period flat choroidal detachment and widespread retinal detachment involving the macular region were detected. During observation and prescription of anti-inflammatory and cycloplegic therapy, resolution of the exudative process was noted 1 month after surgery. 

Conclusion. Despite the peculiarities of the postoperative course, trabeculectomy is one of the effective methods of surgical treatment of secondary glaucoma in Sturge-Weber syndrome.

The article presents a cases series of retinoprotective therapy (RPT) using the water-soluble retinal polypeptide fractions (RPF). The 1st case: the nonproliferative diabetic retinopathy (DR) and cystoid macular edema patient after the 1st year of anti-VEGF therapy and retinal laser coagulation (RLС), which resulted in foveal retinal edema relief, a decrease in its intensity in the paraand perifovea, an increase of the best-corrected visual acuity (BCVA) from 0.03 up to 0.2, and the perimetric indices deviations (MD -12.86 dB; PSD 7.99 dB) relative to normal values. Three courses of RPT were administrated during the 2nd year of anti-VEGF therapy. BCVA increase (up to 0.3), MD normalization (-1.65 dB) and PSD decrease (4.96 dB) were noted 1month after the 3rd course of RPT. The 2nd case: the proliferative DR patient after subtotal 25-G vitrectomy, endo-RLC and silicone oil (SO) tamponade. MD (-8.04 dB) and PSD (4.61 dB) deviations were recorded 1-month after surgery. BCVA stabilization (0.3), MD improvement (-5.43 dB), PSD stabilization (4.61 dB) were noted 1-month after RPT. The 3rd case: the patient with low BCVA (0.08), MD (-14.15 dB) and PSD (7.86 dB) deviations 1-month after vitreous cavity revision with perfluorocarbon (PF) tamponade, endo-RLC and PF replacement with SO due to recurrent retinal detachment after the indirect non-open glob blunt injury. BCVA improved (0.2), MD decreased (-9.38 dB), and PSD stabilized (7.54 dB) one month after RPT. All patients noted improved quality of vision after RPT. The presented clinical cases, as well as many years of experience with the effective and safe use of RPF in patients with retinal pathology, provide grounds for recommending RPT after RLC and vitrectomy in patients with DR and retinal detachment.

Dry eye syndrome is a global problem of the modern world. Overload of information, rapid urbanization, and a busy lifestyle lead to non-compliance with work and rest schedules, including increased visual loads, decreased stress resistance in conditions of time deficit, leading to a deficiency of vital substances in the body. All the above are risk factors for the development of dry eye syndrome and affect the course of this disease. It is a well-known fact that balanced nutrition, regular intake of vitamins and microelements with food, and compliance with work and rest schedules play a role in the prevention and elimination of clinical manifestations of these conditions. This article presents the results of using the biologically active food supplement “DOPPELHERZ® V.I.P. OFTALMOVIT No. 30” (manufacturer Queisser Pharma GmbH & Co. KG, Germany) in the treatment of dry eye syndrome.

 The purpose of the study: to evaluate the effect of the dietary supplement “DOPPELHERZ® V.I.P. OFTALMOVIT no. 30” in the treatment of dry eye syndrome.

 Material and methods. The study included 90 students with dry eye syndrome, aged 18 to 26 years. Patients of group I (control) did not receive any dietary supplements; group II (study group) received the dietary supplement “DOPPELHERZ® V.I.P. OFTALMOVIT”. 

Results. OSDI questionnaire — in the study group, the severity of dry eye syndrome: “before” moderate n = 38, severe n = 22, “1 month” moderate n = 43, severe n = 17, “2 months” mild n = 11, moderate n = 43, severe n = 6, in the control group no changes (p = 0.368). Norn’s test: the study group showed an increase in tear film breakup time (p < 0.001), no changes were recorded in the control group (p = 0.285). Lacrimal meniscus height: the study group showed an increase in the height of the lacrimal meniscus, which indicates an improvement in the functional properties of the tear film and a decrease in dry eye syndrome (p < 0.001), no changes were recorded in the control group (p = 0.105). Schirmer tests 1 and 2: the study group showed an increase in the tear film breakup time, which indicates an improvement in the functional properties of the tear film and a decrease in dry eye syndrome, no changes were recorded in the control group (RSH1 = 0.587, RSH2 = 0.293). CISS questionnaire: a gradual decrease in the severity of asthenopia signs was observed in the study group (p < 0.001), no changes were recorded in the control group (p = 0.125). Pupillography: in the study group, regression of accommodation tension was recorded, more pronounced after 2 months (p < 0.001), in the control group there was a change in accommodation tension, which can be associated with the alternating predominance of sympathetic and parasympathetic wagging (p < 0.05). 

Discussion. The concept of dry eye syndrome treatment includes etiopathogenetic, non-specific and symptomatic therapy. An integral link in the strategy of pathogenetic treatment of dry eye syndrome is the targeted introduction of vitamins and microelements into the diet. 

Conclusion. Based on the results of the study, as well as on the data of foreign and domestic authors, dietary supplements can serve as an additional source of vitamins and microelements, the deficiency of which is one of the components of the causes of dry eye syndrome pathogenesis. Considering the above, we can recommend taking the dietary supplement “DOPPELHERTS^® V.I.P. OFTALMOVIT” 1 capsule once a day for 2 months in the complex therapy of patients with dry eye syndrome.

Purpose: to study the parameters of the cornea and anterior chamber of the Soviet Chinchilla rabbit by Scheimpflug imaging, OCT of the anterior segment and endothelial biomicroscopy. 

Methods. Photoregistration, scheimpflug tomography, OCT, and endothelial biomicroscopy of the cornea under intravenous anesthesia were performed on 30 eyes of 30 male rabbits. Statistical data processing was performed using the SPSS 26.0 software package. 

Results. The obtained data of optical and morphometric parameters corresponded to similar parameters of the New Zealand white rabbit. In 32.5 %, the cell area was in the range from 400 to 500 microns, in 31.9 % — in the range of 300–400 microns, and in 11.6 % and 14.0 % it was in the range of 200–300 and 500–600 microns, respectively. The majority of cells (56.6 %) were represented by hexagonal cells, 20.3 % — pentagonal and 16.6 % — heptagonal. The amount of reverse light scattering of the cornea decreases in all layers from the center to the periphery. According to OCT data, the average thickness of the rabbit cornea epithelium was 44.19 ± 5.10 microns, the average thickness of the stroma was 343.23 ± 41.40 microns, the thickness of the cornea as a whole in the central zone was 388.37 ± 41.45 microns. The correlation analysis data showed the presence of a strong and moderate relationship between the volume of the anterior chamber, the diameter of the pupil and the magnitude of the iridocorneal angle. 

Conclusion. Optical and morphometric characteristics of the cornea and anterior chamber of the Soviet Chinchilla rabbits eye can be useful in planning experiments using these animals in ophthalmology. There were no significant differences in the refractive and morphological properties of the cornea between rabbits of the Soviet Chinchilla breed and the New Zealand white rabbit. The direct relationship between the volume of the anterior chamber, the diameter of the pupil and the magnitude of the iridocorneal angle, which is significant for the hydrodynamics of watery moisture and surgical manipulations on the anterior segment, is of interest.

Objectives: to evaluate the feasibility of reducing exposure time during transscleral laser cyclothermotherapy (TLCTT) by applying a pulsedperiodic laser mode in an experimental setting. 

Methods. The study was conducted on Chinchilla rabbits of both sexes, weighing 1.5–2.0 kg. Animals were divided into two groups. The control group (20 rabbits, 40 eyes) underwent TLCTT using a continuous laser mode (0.3 W, 16 s). The experimental group (10 rabbits, 20 eyes) received TLCTT with a pulsed-periodic laser mode (duty cycle 50 %, pulse period 1 s), at 0.6 W for 8 s. Biomicroscopy was performed one day after the procedure to evaluate inflammatory response, and macroscopic examination of ciliary body specimens was carried out to assess the characteristics of destruction foci. 

Results. Biomicroscopy revealed mixed conjunctival injection in all animals, with moderate chemosis in 45 % of eyes in the control group and 50 % in the experimental group. Aqueous humor opalescence of moderate intensity was noted in 75 % and 80 % of eyes, respectively. No precipitates, posterior synechiae, or fibrinous deposits were observed. Macroscopically, destruction foci appeared as pale areas of ciliary processes with comparable diameters (1.35 ± 0.07 mm in the control group and 1.34 ± 0.08 mm in the experimental group, p = 0.3). No rupture-associated mechanical effects were detected in either group. 

Conclusion. The pulsed-periodic laser mode achieved destruction foci of comparable size to conventional TLCTT, without inducing additional mechanical damage or excessive postoperative inflammation. The shortened exposure time reduces the risk of light guide displacement during the procedure, potentially improving both safety and effectiveness.

The article discusses the current state and prospects for the use of artificial intelligence (AI) in ophthalmological practice. The main areas of AI application are described, including automated diagnostics of eye diseases, personalized treatment, prognosis of the course of diseases and support of surgical interventions. An analysis of the existing approaches and technologies, such as deep learning and computer vision, which are used to analyze medical images and data, is provided. Particular attention is paid to data standardization, safety and ethical aspects of introducing AI into clinical practice. The importance of cooperation between specialists in different fields for the effective implementation of innovative technologies and improving the quality of medical care is emphasized.