Modern research demonstrates the important role of sensory deprivation in the development of age-related cognitive impairment, decreased functional independence, and an increased risk of dementia. One of the most significant age-related changes in the visual system is the progressive decrease in lens transparency, accompanied by a significant decrease in the transmission of short-wavelength light to the deeper neurosensory structures of the eye. Short-wavelength light in the range of 457–464 nm exhibits maximum efficiency in activating melanopsin-containing retinal ganglion cells (ipRGCs). This photosensory system plays a key role not only in the regulation of circadian rhythms through the suprachiasmatic nuclei of the hypothalamus and the suppression of melatonin secretion, but also in broader mechanisms of neuroendocrine regulation, including the circadian organization of hormonal rhythms, control of activity levels, and the body's adaptive processes. Moreover, age-related lens hardening and yellowing lead to a decrease in the amount of this spectrum reaching the retina [6,7], which can potentially contribute to sleep disturbances, circadian desynchronization, decreased motor and social activity, and a decrease in cognitive reserve due to a weakening of the light signal necessary to maintain the internal biological clock. This paper hypothesizes that surgical replacement of the aging lens with a modern intraocular lens can not only improve visual function but also potentially contribute to a partial restoration of physiological light stimulation of the circadian and neuroendocrine systems of the brain. We present our own preliminary clinical observations after bilateral implantation of the AT LISA tri trifocal intraocular lens in 100 patients aged 55–65 years. A conceptual model, "Vision → Brain → Longevity," is proposed. It postulates that restoring light transmission in the ocular optical system can influence circadian regulation, sleep quality, activity level, cognitive health, and functional longevity indicators. This proposed concept is hypothetical in nature and requires further testing in specifically designed prospective studies. It opens new avenues for interdisciplinary research at the intersection of ophthalmology, circadian biology, neuroendocrinology, and gerontology.

Both dementia and cataracts represent serious medical and social issue, as they are the leading causes of disability among the elderly population. Main hypotheses linking these age-related health problems are shared pathophysiology, sensory deprivation, circadian rhythm disruption, influence of neurodegenerative processes and general risk factors. Several studies indicate a potential link between the deterioration of visual function due to cataract formation and the progression of cognitive functions in older patients. Cataract extraction can be considered a guaranteed intervention aimed at reducing the risk of the incidence and progression of cognitive impairment. Further research is needed to clarify the role of cataract extraction in the progression of already developed dementia.

The literature review focuses on the capabilities of modern high-tech methods for examining the lens, the implementation of which in clinical practice is essential for enhancing the effectiveness of cataract diagnosis. Biomicroscopy with lens image registration, including retroillumination for subjective cataract assessment according to the LOCS III classification, remains a widely used method for evaluating lens status. However, despite its versatility, this approach is characterized by significant dependence on the investigator’s experience and qualifications. In an era where contemporary cataract surgery has achieved high standards and shifted emphasis toward patient visual quality, existing subjective diagnostic methods prove inadequate. In recent years, objective methods for lens examination have gained practical significance, enabling the most accurate detection of early age-related lens changes with quantitative assessment of opacity severity. One such method is ultrasonic densitometry. The most common technique for quantitative lens evaluation is optical densitometry using Scheimpflug cameras and computer software for objective assessment of opacity localization and progression dynamics. Other highly informative optical methods for detecting various stages of age-related cataract include wavefront aberration analysis with determination of the light scattering index via double-pass technology, as well as the use of the Shack-Hartmann wavefront sensor. Optical coherence tomography (OCT) with variable wavelength and a high-frequency detector allows high-resolution visualization of lens layer changes, substance degradation, and the presence of vacuoles and lysis zones in cataract. In modern ophthalmology, high-tech methods for quantitative assessment of lens optical density are becoming indispensable not only for determining indications for surgical intervention, selecting optimal phacoemulsification regimens, and preventing intraoperative complications, but also for monitoring cataract progression in clinical trials and evaluating the efficacy of pharmacological correction for initial age-related lens opacities.

Stargardt disease (STGD1) is the most common type of inherited macular degeneration. It is an autosomal recessive disorder caused by pathogenic variants in the ABCA4 gene, which encodes a transmembrane protein of the ATP-binding cassette transporter. This protein is located in the outer segments of photoreceptors and is essential for retinal recycling. Dysfunction of the ABCA4 transporter leads to the accumulation of toxic vitamin A metabolites in retinal pigment epithelial cells and subsequent photoreceptor degeneration. Recently, fundamental and translational studies on the molecular pathophysiology of inherited retinal diseases, including Stargardt disease, have significantly improved the understanding of their mechanisms, leading to the stimulation and development of new therapeutic strategies. The purpose of this review is to describe current approaches aimed at correcting the genetic defect in STGD1 and to analyze their advantages and limitations in terms of potential clinical use. The first part of the review examines non-viral gene therapy technologies as applied to the treatment of Stargardt disease.

Inflammatory diseases of the cornea, its injuries and burns are the leading causes of decreased vision, blindness and death of the eye. The search for the new and effective methods of treating corneal diseases with a recurrent course is a pressing issue. This article is devoted to modern information on the possibilities of using Amniotic Membrane (AM) in the treatment of patients with severe corneal pathology: persistent epithelial erosions, corneal perforations and disorders associated with limbal stem cell deficiency. The advantages and disadvantages of various methods of AM preservation, methods of using AM in surgical and conservative treatment, as well as various complications that may be encountered when using AM are presented.

One of the important criteria for visual quality and satisfaction after uncomplicated cataract surgery is achieving the “target refraction” without residual ametropia. Despite the availability of highly accurate preoperative assessment and advanced formulas for calculating the optical power of intraocular lenses (IOLs), failure to achieve a postoperative refraction within ±0,5 diopters of the target still occurs in approximately one quarter of cases. The problem is further complicated by the absence of a generally accepted consensus regarding the optimal IOL power calculation formulas for hyperopia or myopia. In addition to various options for postoperative refractive correction, promising approaches include the use of IOLs with adjustable optical power after implantation and new-generation artificial intelligence-based IOL power calculation formulas.

The review analyzes data from 57 original studies available in accessible sources on the use of vascular endothelial growth factor inhibitors in the treatment of Coats’ disease (CD). It has been established that intravitreal administration of angiogenesis inhibitors is a simple, effective and safe additional method for the treatment of severe stages of CD, refractory macular edema and type 3 neovascularization. However, given the variability of clinical presentations, treatment regimens and limited number of observations, further studies are needed to determine clear indications and optimal anti-VEGF therapy regimens for this disease.

Relevance. Cataracts and age–related macular degeneration (AMD) are a common combined pathology in patients of the older age group. Selecting an intraocular lens (IOL) in such patients remains a difficult task. Traditionally used monofocal IOLs do not satisfy the growing demands of AMD patients for eyeglass independence. The new EDOF (extended depth of focus) technology occupies an intermediate position between monofocal and multifocal IOLs, providing an extended range of vision with a minimum number of dysphotopsias.

Purpose. Based on the analysis of literature data, to evaluate the advantages of EDOF lens implantation in patients with AMD-complicated cataracts.

Materials and methods. The analysis of publications in the databases PubMed, Scopus, Web of Science, Google Scholar is carried out.

Results. EDOF lenses demonstrate high efficiency in assessing longand medium-range visual acuity, accompanied by a low incidence of dysphotopsia in patients with healthy retinas. In the early stages of AMD, the implantation of EDOF lenses allows achieving satisfactory functional results that exceed the performance of monofocal IOLs. While in the late stages of AMD, the effectiveness of EDOF lenses decreases in proportion to the degree of central vision impairment. The prognostic success factors are the initial visual acuity, the preservation of the foveolar structure according to OCT data, and the stable course of AMD.

Conclusion. The implantation of IOLs with extended depth of focus (EDOF lenses) in patients with age-related macular degeneration is a promising area of research. The lack of large prospective studies and insufficient knowledge of long-term results do not allow us to introduce a clear algorithm for selecting the studied group of patients.

In recent decades, the widespread use of digital technologies, increased life expectancy, and sustained professional and social activity among older adults have significantly raised expectations for visual performance at multiple working distances. In patients with presbyopia and age-related cataract undergoing intraocular lens (IOL) implantation, the assessment of visual function at far, intermediate, and near distances has therefore become increasingly important. However, in clinical practice and scientific research there is still no single standardized approach to determining the metric values of these distances. This narrative review analyzes Russian and international publications, regulatory documents, professional guidelines, and manufacturer data related to the assessment of visual acuity at far, intermediate, and near distances. The review demonstrates that distance visual acuity is evaluated at varying test distances ranging to 6 m. Intermediate viewing distance shows the greatest variability, ranging from 50 to 80 cm across studies, largely reflecting differences in visual tasks and typical distances to digital devices. Near visual acuity is most commonly assessed at distances of 33–40 cm. Special attention is given to defocus curves as an adjunctive method for evaluating depth of focus and functional visual performance in pseudophakic patients. The limitations of interpreting defocus curves without direct correlation to real-distance visual acuity measurements are discussed. The need for unification of approaches to assessing vision at an intermediate distance in domestic ophthalmology and the feasibility of using a distance of 66 cm as clinically significant, functionally justified and the most universal seems relevant today.

Scarring of the filtration area remains the main factor limiting the long-term success of non-penetrating glaucoma surgery (NPGS). In filtering glaucoma surgery, not only the condition of the subconjunctival space is important, but also the functionality of the trabeculoDescemet’s membrane, the stability of the intrascleral space volume, and controlled gentle postoperative wound healing. The aim of the study was to develop a clinical and pathogenetic model of scarring after NPGS and to evaluate whether autologous adipose tissue transplantation can be considered a tool for selective immunoregulatory antiproliferative modulation. The review was performed as a structured translational review based on publications available as of March 2026. Analysis of the literature demonstrates that, in NPGS, the critical factor is not maximal suppression of cellular activity, but rather regulation of the wound healing process. This includes control of persistent inflammation, TGF-b-dependent pathways, myofibroblastic transformation, extracellular matrix remodeling, and mechanical stabilization of fibrosis. The potential use of adipose tissue is associated with its complex effects within the transplantation area, including modulation of local inflammation, antifibrotic activity, inhibition of extracellular matrix synthesis, and neutralization of matrix metalloproteinases.

Objectives: to analyze the evolution, mechanisms of action, clinical efficacy, and safety of laser-based modulation of trabecular outflow in the comprehensive management of glaucoma, and to evaluate current and emerging laser technologies aimed at improving intraocular pressure control.

Methods. A structured analysis of experimental and clinical studies describing laser techniques for trabecular modulation was performed. The review included argon laser trabeculoplasty, selective laser trabeculoplasty, Nd:YAG-based hydrodynamic activation methods, excimer laser trabeculostomy, and infrared laser approaches. Data on the action mechanisms, treatment parameters, intraocular pressure reduction, durability of effect, complication profile, and impact on medication burden were assessed based exclusively on the presented material.

Results. Argon laser trabeculoplasty demonstrated a mean intraocular pressure reduction of approximately 30 %, but its long-term efficacy declined over time and was associated with postoperative pressure spikes and structural alterations. Selective laser trabeculoplasty provided a 21.8–29.4 % reduction within six months, with a favorable safety profile and reduced tissue damage; however, the median duration of effect was approximately two years. Nd:YAG-based activation techniques showed significant intraocular pressure reduction and decreased medication burden, though repeat procedures were required in a subset of patients. Excimer laser trabeculostomy achieved sustained pressure reduction with a stable long-term effect and minimal thermal injury, supporting its role within minimally invasive glaucoma surgery. Infrared laser systems, particularly those targeting wavelengths with high water absorption, demonstrated promising experimental precision but were limited by technical delivery constraints.

Conclusion. Laser modulation of trabecular outflow represents an effective and relatively safe strategy for intraocular pressure reduction in primary open-angle glaucoma. Despite proven clinical benefit, durability of effect remains a limitation for several techniques. Further refinement of laser parameters and development of optimized delivery systems are essential to enhance long-term outcomes in glaucoma surgery.

The presented literature review is devoted to an important OCT biomarker of retinal diseases; hyperreflective foci (GRF); which are considered as a promising indicator of inflammatory processes and vascular disorders of the retina. The purpose is to clarify modern ideas about the nature and classification of hyperreflective foci as an important diagnostic marker. This is necessary to improve the accuracy of diagnosis and monitoring of the most common retinal diseases; as well as to develop personalized treatment approaches; including using artificial intelligence technologies in ophthalmology. GRFs are defined as discrete point or rounded structures with increased optical density; ranging in size from 20 to 100 microns; localized within the retinal layers or in the subretinal space. GRF is not a specific morphological feature; but a universal phenotype reflecting a wide range of pathophysiological processes. The article describes in detail the morphology of foci; the pathogenetic mechanisms of their formation; the prognostic role and differences in age-related macular degeneration; diabetic retinopathy; diabetic macular edema. The correct differential interpretation of GRF requires an integrated approach; including an analysis of medical history and risk factors; a detailed assessment of their localization and morphological characteristics; as well as consideration of concomitant OCT signs and multimodal imaging data. The integration of these parameters makes it possible to accurately determine the nature of hyperreflective foci; choose the optimal patient management tactics; and reasonably predict the course of the disease.

Microcystic macular edema (MME) is a common but poorly understood complication of epiretinal membrane (ERM) surgery.

Purpose. To study the incidence, risk factors, characteristics of MME and it’s impact on functional outcome of ERM surgery with internal limiting membrane peeling.

Material and methods. The outcomes of ERM surgery in 56 patients (58 eyes) were retrospectively assessed; the prevalence and characteristics of MME, as well as OCT data, surgical characteristics, and their relationship with best-corrected visual acuity, were investigated.

Results. Intraretinal cysts was detected before treatment in 34 (58.6%) cases, 1 month after surgery in 24 (41.3 %), and 1 year after surgery in 22 cases (37.9 %). Microcysts were more common in the nasal subfield — 18 (81.8 %) and central subfield — 16 (72.7 %). MME after 1 year was significantly more common in the presence of ectopic inner foveal layers: 86.4 % versus 58.3 % (p = 0.04) and greater retinal thickness: 460.4 ± 109.8 versus 347.7 ± 109.7 (p < 0.001), respectively. The frequency and severity of petechial hemorrhages that occurred intraoperatively in the groups with and without MME did not differ significantly (p = 0.097), while the “wave” symptom in the group with MME occurred in 63.6 % and without MME in 16.7 % of cases (p < 0.001). The BCVA in the group with MME after 1 year was 0.66 ± 0.28 and was significantly lower than in the group without MME — 0.86 ± 0.15 (p = 0.009). When analyzing the influence of microcystic localization on BCVA, the only significant factor was the presence of microcysts in the central subfield (p = 0.026).

Conclusions. MME is a frequently encountered OCT sign accompanying ERM surgery. The expected outcome is worsened by the appearance of MME more than a month after ERM removal and localization of microcysts in the central 1 mm subfield, which leads to a significantly lower BCVA. The presence of ectopic inner foveal layers (ERM stages 3 and 4), schisis of nerve fiber layer and greater retinal thickness, as well as the intraoperative “wave” symptom, increases the likelihood of developing MME.

The treatment of patients with open globe injuries, including cases involving intraocular foreign bodies (IOFBs) in the projection of the ciliary body, remains a challenging clinical task.

Objective. To summarize surgical tactics for extracting intraocular foreign bodies (IOFBs) from the ciliary body (CB) area.

Material and methods. Four cases of open globe injury with IOFBs near the CB (2022–2023) were analyzed. Diagnostics included ultrasound, CT, and X-ray localization. All patients underwent IOFB removal via a combined approach (transvitreal and anterior). Follow-up: 7 ± 2 months.

Results. Combined approach modifications were used: phacoemulsification, hemvitrectomy with posterior vitreous detachment (PVD), and extraction through a posterior capsulorhexis or temporary keratoprosthesis. Retinal “ricochet zones” found in 50% of cases required endolaser photocoagulation. Visual acuity improved in all patients; no complications occurred.

Conclusion. Extracting IOFBs from the CB area requires specific techniques, such as scleral indentation and a combined surgical path. A 50 % incidence of retinal “ricochet zones” necessitates mandatory vitrectomy with PVD and preventive laser coagulation.

Objective: to evaluate the clinical efficacy and safety of sustained intraocular pressure (IOP) reduction without increasing medication load in patients with open-angle glaucoma (POAG) at various stages after MicroPulse Transscleral Cyclophotocoagulation (MP-TSCPC) over a 12-month follow-up period.

Patients and Methods. The study included 45 patients (48 eyes), 29 males and 16 females, aged 72.9 ± 7.7 years, with initial, developed, advanced, and terminal stages of POAG. Patients with secondary glaucoma or prior cyclodestructive procedures were excluded. MP-TSCPC was performed using the IRIDEX Cyclo G6 Glaucoma Laser System (USA), with a safe total energy range of 100–150 J. Follow-up lasted 12 months, with examinations on postoperative days 1 and 7, and at 1, 3, 6, and 12 months. Preoperatively, all patients were on topical hypotensive therapy (mean 2.4 ± 0.8 medications).

Results. MP-TSCPC significantly reduced IOP. Mean baseline IOP was 26.8 ± 4.8 mmHg, decreasing to 19.5 ± 3.6 mmHg on day 1, 16.7 ± 3.1 mmHg at 7 days, 18.2 ± 3.0 mmHg at 1 month, 18.3 ± 2.8 mmHg at 3 months, 18.6 ± 2.8 mmHg at 6 months, and 19.2 ± 3.1 mmHg at 12 months. No reduction in medication load was achieved (2.4 ± 0.8 medications pre- and postoperatively). Best-corrected visual acuity (BCVA) remained stable throughout follow-up (mean 0.5 ± 0.3). One patient (2.2%) developed aseptic endophthalmitis, resolved with conservative treatment, without compromising IOP reduction.

Conclusion. MP-TSCPC is an effective and safe method for IOP reduction in POAG patients across disease stages. The study confirms sustained IOP reduction (28–38 % from baseline) over 12 months, with maximal effect at 7 days post-intervention (16.7 ± 3.1 mmHg). Importantly, medication load remained unchanged (2.4 ± 0.8 drugs), highlighting MP-TSCPC’s role as an adjuvant therapy when conservative treatment fails.

Purpose: comparative analysis of two extended depth of focus IOLs bilateral implantation.

Patients and methods. A total of 60 patients (120 eyes) after bilateral implantation of AcrySof IQ Vivity® IOLs (n = 30, group I) (Alcon, USA) and TECNIS PureSee® (n = 30, group II) (Johnson & Johnson, USA) with an average follow-up period of 6.2 ± 1.1 (3–32) were included in the study months. In the total cohort of patients, 58.3 % (n = 35) were women and 41.7 % (n = 25) were men. The age of the patients ranged from 39 to 81 (59.4 ± 8.0) years.

Results. In both study groups, the postoperative values of UCVA and BCVA at all distances were significantly higher than before surgery (p < 0.05). For both implantable IOLs, the values at the maximum follow-up period of 3 months were comparable (p > 0.1). The results of the analysis of the defocus curve indicate the comparable effectiveness of both studied IOLs for correcting vision near, at an intermediate distance and in the distance. Under photopic conditions, the PureSee group showed significantly higher contrast sensitivity than the Vivity group at 12 cycles/deg (p < 0.05) and 18 cycles/deg (p < 0.05). Under mesopic conditions, this trend continued, and statistically significant differences were again observed at higher spatial frequencies at 18 cycles/deg (p < 0.05). 20.8 % of patients from group I had permanent or periodic optical phenomena, of which 14.2 % had glare and 6.6% had halo. In group II, 6.7 % of patients complained about halo, and 3.3 % complained about glare. None of the patients from the study groups complained of difficulty driving at dusk. The differences between the groups were not statistically significant (p > 0.05).

Conclusion. For the first time in Russia, a comparative analysis of two modern EDOF IOLs has been performed. The studied IOLs were comparable in most of the parameters studied, including uncorrected and maximally corrected visual acuity at all distances, the frequency of adverse optical phenomena, and the degree of patient satisfaction. The advantage of implanting EDOF PureSee IOLs to achieve better contrast sensitivity in photopic and mesopic conditions is shown.

Purpose. To evaluate the dynamics of functional and refractive outcomes, as well as the safety, efficacy, and predictability of transepithelial photorefractive keratectomy (TransPRK) for the correction of myopia and myopic astigmatism using the SCHWIND Amaris 1050RS laser platform at 1, 3, and 12 months postoperatively.

Materials and Methods. A retrospective study included 186 patients (365 eyes) with a mean age of 29.1 ± 7.75 years and varying degrees of myopia (mean -4.92 ± 2.12 D), with and without myopic astigmatism. All patients underwent single-step TransPRK. Comprehensive ophthalmic examinations were performed preoperatively and postoperatively, including assessment of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction (sphere, cylinder, spherical equivalent), as well as evaluation of efficacy, safety, and predictability. Follow-up examinations were conducted at 1, 3, and 12 months. Statistical analysis was performed using nonparametric methods.

Results. A statistically significant improvement in UDVA and CDVA was observed at all follow-up points compared to preoperative values. At 12 months, UDVA of 1.0 was achieved in 100 % of eyes, and 1.2 in 61 % of eyes. Efficacy and safety indices demonstrated positive dynamics, with no loss of CDVA lines observed in any patient by the end of the follow-up period. High predictability of refractive outcomes was confirmed, with 94 % of eyes within ±0.50 D of the target spherical equivalent at 12 months, and 100 % within ±1.00 D. Astigmatism correction was also highly effective, with a mean residual cylinder of 0.00 D at 12 months postoperatively.

Conclusions. TransPRK using the SCHWIND Amaris 1050RS platform is an effective, safe, and highly predictable method for the correction of myopia and myopic astigmatism. By 12 months, excellent functional and precise refractive outcomes are achieved. Optimal results require thorough preoperative evaluation under standardized conditions, careful surgical planning, and adherence to postoperative management protocols. In the studied cohort, no adjustment of manufacturer-provided nomograms was required to achieve the planned refractive outcomes. 

Purpose — to assess the surgical and morphofunctional outcomes of femtosecond laser-assisted phacoemulsification in patients who with previously received intravitreal implantation of a sustained-release dexamethasone implant.

Patients and methods. A prospective comparative study enrolled 123 patients (123 eyes) with grade III nuclear density and 84 patients (84 eyes) with grade IV nuclear density according to the Buratto scale, constituting groups 1 and 2, respectively. Within each group, patients were allocated by surgical approach: subgroups 1A (78 eyes) and 2A (46 eyes) underwent femtosecond laser capsulorrhexis and nucleus fragmentation using the “grid” pattern; subgroups 1B (45 eyes) and 2B (38 eyes) received conventional ultrasound cataract extraction. Intraoperatively, irrigation fluid consumption and effective ultrasound time were recorded. Patients were examined preoperatively, on postoperative days 1 and 3, and at 1 and 3 months after surgery. Corneal endothelial status was assessed with an SP-3000P microscope (TOPCON, Japan) before surgery and 3 months postoperatively; pachymetric measurements were taken preoperatively, on day 1, and at 3 months.

Results. Femtosecond laser-assisted phacoemulsification in patients who had previously received intravitreal dexamethasone depot significantly reduced both the energy and hydrodynamic burden on ocular tissues and limited corneal endothelial cell loss. For grade III cataracts (subgroup 1A), effective ultrasound time was 1.81 (1.02; 2.64) s and irrigation volume was 24.6 (18.6; 30.3) ml; in subgroup 1B these values were 4.27 (2.73; 6.74) s and 57.5 (48.2; 66.9) ml (p < 0.05). Endothelial losses in subgroup 1A reached 4.44 (3.27; 5.64) %, versus 10.91 (7.90; 13.95) % in subgroup 1B (p < 0.05). For grade IV cataracts (subgroup 2A), effective ultrasound time was 4.89 (3.01; 6.74) s and irrigation volume was 43.0 (37.1; 49.5) ml; in subgroup 2B — 9.89 (7.55; 12.33) s and 96.9 (85.4; 109.4) ml, respectively (p < 0.05). Endothelial cell loss in subgroup 2A was 10.67 (8.36; 12.79) % versus 23.69 (18.28; 29.09) % in subgroup 2B (p < 0.05). Visual acuity recovered more rapidly in the femtosecond laser surgery groups. Pachymetric parameters did not differ significantly between groups.

Conclusion. Femtosecond laser-assisted phacoemulsification outperforms standard ultrasound technique across morphofunctional criteria in patients after intravitreal dexamethasone depot implantation.

Purpose: tо conduct a prospective analysis of functional outcomes in children with cicatricial retinopathy of prematurity (ROP) after vitreoretinal surgery performed during the active phase of the disease from 2012 to 2024.

Methods. In 2025–2026, a prospective analysis of the clinical and functional status of 200 children (200 eyes) with cicatricial ROP from various regions of the Russian Federation was performed. All patients underwent surgical treatment during the active phase of the disease between 2012 and 2024. In the cicatricial phase of ROP (at ages 1 to 13 years), all children underwent a comprehensive ophthalmological examination, including visometry, autorefractometry, biometry, tonometry, optical coherence tomography (OCT), B-mode ultrasound, and electrophysiological studies.

Results. High functional outcomes (BCVA ≥ 0.3) were achieved only in surgeries for stages 3 and 4a, accounting for 31.9 % of all eyes with assessed visual acuity. For stages 4b, 5, and aggressive posterior ROP, the proportion of eyes with BCVA below 0.2 reached 68 %. Astigmatism was detected in 97.6 % of cases, and myopia in 72.6 %. OCT findings revealed foveal pit flattening (38.2 %), foveal hypoplasia (36.2 %), and retinal nerve fiber layer thinning (95.4 %). Clinically significant ocular hypertension was registered in 10.6 % of cases.

Conclusion. Even with anatomical success of vitreoretinal surgery for active ROP, functional outcomes remain limited, especially for initial stages 4b, 5, and aggressive posterior ROP. The obtained data can serve as a basis for optimizing the timing of surgical intervention, developing rehabilitation programs, and predicting long-term outcomes in children with ROP.

Obesity is an established risk factor for cardiovascular disease, arterial hypertension, and lipid metabolism disorders leading to atherosclerosis and drusen formation. An association between obesity and age-related macular degeneration (AMD) has been demonstrated. Obesity may be associated with AMD either directly or indirectly through diabetes mellitus, hypertension, dyslipidemia, or disturbances of metabolic processes in ocular tissues.

Purpose. To evaluate the role of obesity as a comorbid condition and a risk factor for a suboptimal response to anti-VEGF therapy.

Patients and Methods. This prospective cohort study included 318 patients with macular neovascularization (MNV; 318 eyes), aged 50–93 years, including 210 women and 108 men. All types of refractive error, ranging from+6.0 to -16.0 diopters, were represented. The diagnosis was established according to the International Classification of Diseases, 10th Revision (ICD-10; H35.3). Best-corrected visual acuity (BCVA) was assessed using the Snellen chart. Intraocular pressure (IOP) was measured, and slit-lamp biomicroscopy of the anterior and posterior segments of the eye, ophthalmoscopy, optical coherence tomography (OCT), and OCT angiography (OCTA) were performed. Patients with active MNV were treated with intravitreal aflibercept injections administered according to a fixed regimen in compliance with the Russian federal clinical guidelines.

Results. Of the 318 patients with MNV, 97 (30.4 %) had class I–II obesity, while 141 patients were overweight. Nearly one in three patients with MNV was overweight. Despite successful resolution of subretinal exudation and a reduction in pigment epithelial detachment (PED) in both groups of patients with MNV, the therapeutic response was less pronounced in patients with obesity. OCT demonstrated delayed regression of the intraretinal fluid (IRF) area, which began only after the fourth injection. During the first three intravitreal injections, exudation continued to increase slowly and accumulate. The differences became increasingly evident and reached statistical significance by the final injection of the loading phase (p < 0.05). Overall, fluid resolution was less effective in patients with obesity. This was reflected in the final BCVA outcome.

Conclusions. Obesity aggravates the clinical course of MNV and adversely affects the outcome of anti-VEGF therapy. Disease progression despite courses of intravitreal injections occurred twice as frequently in patients with obesity (10.3 % vs 5.0 %; p = 0.09). During treatment, intraretinal fluid resolved more slowly, which affected the functional outcomes.

Introduction. Early diagnosis of the chiasmal compression of surgical treatment and prevention of the development of persistent visual impairment.

Introduction. Early diagnosis of the chiasmal compression will help maintain high visual function and improve the quality of life of patients with pituitary adenoma. (PA).

Purpose. Analysis of microcirculation parameters of the macular region and optic nerve head using optical coherence tomography angiography (OCTA) in patients with PA.

Patients and methods. Ninety-two patients (92 eyes) with PA and 46 healthy individuals (46 eyes) were examined. Patients were divided into three groups depending on the presence or absence of OCT changes (decrease in the thickness of the retinal nerve fiber layer and/or the ganglion cell layer + inner plexiform layer complex) and visual field defects according to static automated perimetry (SAP): Group 1 — no changes in OCT and SAP parameters, Group 2 — no OCT changes in the presence of SAP changes, Group 3 — presence of OCT and SAP changes. OCTA was performed on a REVO nx/SOCT Copernicus REVO device.

Results. In patients of group 1, a statistically significant increase in the average vessel density (VSD) of the superficial capillary plexus (SRCP) and VSD of the SRCP in the perifoveolar region (p < 0.0001) was revealed. In patients of groups 2 and 3, statistically significant changes in perfusion density (VAD) and VSD of the SRCP were not revealed. The VSD and VAD of the deep capillary plexus in patients with PA of all groups did not differ from the indicators in the control group. Patients of group 2 were characterized by a significant decrease in VAD of the radial peripapillary capillary plexus (RPCP) in the superior peripapillary region and in the inferior temporal sector (p < 0.0001), while patients of group 3 had a significant decrease in VAD of the RPCP in the peripapillary region and in all sectors of the optic nerve head (p < 0.0001).

Conclusion. OCTA-parameters can be used in a comprehensive and screening assessment of the state of visual functions in patients with suspected of PA and with an already established diagnosis, as well as for drawing up a plan for their dynamic monitoring with the aim of timely prescription of surgical treatment and prevention of the development of persistent visual impairment.

Рurpose: tо develop and comprehensively evaluate the clinical efficacy of the method for the restorative treatment of functional visual impairment in patients with mild traumatic brain injury (MTBI).

Patients and Methods. We observed 83 patients of the main group (MG, aged 27.5 ± 1.4 years) and 75 patients of the control group (CG, aged 26.1 ± 1.4 years) with the following inclusion criteria: verified diagnosis of MTBI, presence of accommodative asthenopia, absence of pronounced asthenopic complaints before injury, duration of daily work and everyday visual load of at least 4 hours, absence of ophthalmological pathology in the anamnesis (except for refractive errors within the spherical equivalent of up to -2.5 D and +1.0 D). Patients in the CG were prescribed traditional neurological and general somatic therapy. Patients in the MG, in addition to traditional therapy, underwent, starting from 3–5 days after the injury, comprehensive restorative treatment (ophthalmorehabilitation) using a technique developed by the authors based on the effects of transcranial magnetic therapy, direct infrared low-energy non-contact laser irradiation of the ciliary muscle of the eye, optical-reflex training, ophthalmochromotherapy, training of the bifixation reflex mechanism, and a set of therapeutic procedures for dysfunction of the meibomian glands. An assessment of the functional state of the visual analyzer was performed in both groups before and after the course of treatment using objective accommodation parameters, validated questionnaires assessing the severity of asthenopia, general asthenia, dry eye syndrome, convergence insufficiency, and the level of visual performance.

Results. The implementation of restorative treatment (MG) is characterized (in comparison with the CG) by a pronounced, statistically significant (from p < 0.05 to p < 0.01) improvement in objective accommodation parameters (by 3.9–16.0 %), a decrease in the subjective assessment of asthenopia (by 3.2–7.2 %), general asthenia (by 12.8 %), symptoms of dry eye syndrome and convergence insufficiency (by 8.8–10.1 %), as well as an increase in the level of visual performance (by 15.4–18.0 %).

Conclusion. The obtained results reflect the medical and social approach to ophthalmic rehabilitation in MCBI. Practical application of the proposed restorative treatment of functional visual impairment in patients with MCBI (especially patients engaged in visually intense work) will ensure the achievement of the required level of visual performance and prolongation of professional longevity.

The purpose: a comprehensive assessment of hypertension as a comorbid disease and a potential risk factor for an adverse response to anti-VEGF therapy in MNV.

Materials and Methods. This prospective cohort study included 321 patients with MNV (321 eyes), aged 50–93 years, including 210 women and 111 men. All types of refractive error, ranging from +6.0 to -16.0 diopters, were represented. The diagnosis was established according to the International Classification of Diseases, 10th Revision (ICD-10; H35.3). Best-corrected visual acuity (BCVA) was assessed. Intraocular pressure (IOP) was measured, and slit-lamp biomicroscopy of the anterior and posterior segments of the eye, optical coherence tomography (OCT), and OCT angiography (OCTA) were performed. Patients with active MNV were treated with intravitreal aflibercept injections administered according to a fixed regimen in compliance with the Russian federal clinical guidelines.

Results. Hypertension (AH) was assessed as a comorbid disease that worsens the clinical course of MNV and a risk factor for an adverse response to antiangiogenic therapy. Hypertension was found in the cohort of MNV (321 people, 321 eyes) in 35 % of cases. It was found that patients with MNV with AH + were about 2 years older than patients without AH, 51% of them were over 75 years old, 50.9 % had atherosclerosis, 30.4 % suffered from diabetes mellitus; and 38.2 % had grade 1–2 obesity. In 93.8 % of cases, their SBP exceeded 140 mmHg, in 36 % of their DBP exceeded 90 mmHg. The marker of AH + had signs of background vascular retinopathy (in 72 % of cases, the symptom of Guist was present). The effectiveness of antiangiogenic therapy was comparable: 43.5 % of non-responders were present with MNV without AH, compared to 51% in the MNV group with AH+ (n/a; p = 0.22), despite the fact that patients with MNV with AH+ had to be transferred to another drug twice as often. In AH, subretinal fluid (SRF) and intraretinal fluid (IRF) were less well resorbed. By the beginning of treatment, the frequency of SRF in MNV without AH was 53.3 % versus 66.1 % in the AH+ group (n/a), during treatment it decreased to 47.0 % in the group without AH, and 63.0 % in the group with AH+. Intergroup differences in the frequency of SRF at the end of the loading course were regarded as a strong tendency (p = 0.08) to decrease the therapeutic effect in AH+.

Conclusions. Thus, hypertension is the most common comorbid disease in the cohort of patients with MNV: it occurs in 35 % of cases. Despite the fact that, in general, the frequency of non-compliance in response to antiangiogenic therapy in patients with comorbidity of MNV and AH is comparable to that of patients with MNV without AH (51.0 % vs. 43.5 %, n/a), nevertheless, the probability of transfer to another drug for various clinical indications increases 2 times more often.

Objective: to analyze the effectiveness of micropulse transscleral cyclophotocoagulation (MPTC) in combination with focal applications of full-pulse transscleral cyclophotocoagulation (FPTC) of the ciliary body in patients with refractory glaucoma.

Patients and methods. A total of 36 patients (36 eyes), 16 women and 20 men, with a history of refractory terminal glaucoma participated in this openlabel, prospective study. They ranged in age from 37 to 91 years and had a hypotensive medication use ratio of 3.0. Inclusion criteria included refractory glaucoma, primary open-angle terminal glaucoma, and subjective complaints of eye and temporal pain. All patients were divided into two groups based on surgical treatment strategy. The main group (16 patients, 16 eyes — 2 patients with IOL subluxation, 3 patients with operated pseudoexfoliative glaucoma, 3 patients with silicone tamponade, 5 patients with iridocorneal adhesion, 3 patients with neovascular glaucoma) received combined MCFC with TCFC, with an average IOP before surgery of 48.1 mm Hg. The control group (20 patients, 20 eyes — 3 patients with IOL subluxation, 4 patients with operated pseudoexfoliative glaucoma, 3 patients with silicone tamponade, 6 patients with neovascular glaucoma) received only MCFC with an average IOP before surgery of 46.3 mm Hg. Comparative evaluation of effectiveness was carried out based on the average intraocular pressure (IOP) in the early (1 day) and late (1 and 6 months) periods. postoperative period.

Results. The average IOP in the study group in the early postoperative period (1 day — 28.6 mm Hg) was lower than that in the control group (1 day — 29.8 mm Hg). In the late postoperative period, between 1 month and 6 months, the average IOP in the study group also decreased more effectively (1 month — 23.8 mm Hg, 6 months — 17.0 mm Hg) than in the control group (1 month — 27.4 mm Hg, 6 months — 23.6 mm Hg). After 6 months, the average IOP in the study group was 28% lower than in the control group. The rate of antihypertensive drug use after 6 months was 2.4 in the study group, while it remained 3.0 in the control group. The average IOP of the main group was lower than similar indicators in the control group at all stages of postoperative observation.

Conclusion. This study presents the comparative effectiveness of using MCFC in combination with focal TCFC of the ciliary body in patients with refractory glaucoma in terms of the hypotensive effect, reduced use of antihypertensive medications, and the absence of postoperative complications.

Purpose: tо evaluate the effectiveness of a stepwise approach to the management of patients with glaucoma based on the sequential use of methods aimed at preservation, restoration, and, if necessary, creation of new pathways for aqueous humor outflow.

Materials and methods. A retrospective observational study included 14 738 patients with different types of glaucoma treated at the ophthalmic clinic “Rascheskov Eye Surgery” between 2015 and 2025. Treatment was performed according to a stepwise strategy including medical therapy, laser procedures, reconstructive interventions, and surgical techniques aimed at creating alternative aqueous humor outflow pathways. The distribution of patients across treatment stages and the rate of intraocular pressure stabilization without signs of glaucoma progression were analyzed.

Results. Stable intraocular pressure was achieved at the compensatory stage in 5309 patients. Reconstructive procedures were performed in 8973 patients, including phacoemulsification with intraocular lens implantation in 6295 cases, laser procedures in 2124 cases, ab interno trabeculotomy in 103 cases, and other types of interventions in 451 cases. Formation of alternative aqueous humor outflow pathways was required in 456 patients, including non-penetrating deep sclerectomy (245), Ahmed glaucoma valve implantation (190), and PRESERFLO microshunt implantation (21). In the majority of cases, intraocular pressure stabilization was achieved without the need for formation of an alternative drainage system.

Conclusion. A stepwise approach to glaucoma treatment based on the sequential use of methods aimed at restoration of physiological aqueous humor outflow and creation of alternative pathways when necessary allows a more structured selection of surgical strategy and provides stable intraocular pressure control in most patients. Reconstructive procedures, including phacoemulsification, play an important role not only in improving ocular hydrodynamics but also in preparing anatomical conditions for possible subsequent glaucoma surgery.

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the musculoskeletal system associated with psoriasis, most commonly manifesting as peripheral arthritis, dactylitis, enthesitis, and spondylitis. Eye inflammation of varying severity and localization can be acute and recurrent. Complications (glaucoma, cataract, macular edema) occur in approximately 25–30 % of uveitis cases. There are limited literature data the regarding the outcomes of surgery for complications of uveitis associated with psoriatic arthritis. This article describes three clinical cases demonstrating the clinical presentation and surgical outcomes of complications in patients of varying ages suffering from recurrent uveitis associated with psoriatic arthritis.

Objective — to evaluate the effect of combined treatment on diagnostic tests of dry eye syndrome in patients with rheumatic diseases.

Material and methods. Prospectively examined 80 patients with rheumatic diseases receiving basic gene-engineered therapy. With rheumatoid arthritis with ankylosing spondylitis 50 patients and 30 respectively. When the diagnostic criteria of dry eye syndrome were identified, patients were prescribed СФЕРО®око.

Results. In patients with rheumatic diseases, a total production disorder was detected in 65 % of OD and 63.75 % of OS. In patients with rheumatoid arthritis, this pathology was detected in 74 % and 70 %, respectively, and in patients with ankylosing spondylitis, it was detected in 53.3 % of cases, with no severe damage and almost equal numbers of mild and moderate damage. In every second patient on OD and slightly more on OS, tear film stability disorders were detected. The results of the Shirmer and Norn tests are affected by the hemogram, the duration of the disease, and the patient’s age.

Conclusion. The use of SPHERO®oko has been shown to be effective in treating dry eye syndrome in patients with rheumatoid arthritis and ankylosing spondylitis who are receiving gene therapy. Additional administration of SPHERO®oko topical therapy leads to normalization of the Schirmer test results (in every second case on OD and in 62.8 % of cases on OS), and a decrease in tear film instability to 33.3 % OD and 14 % OS in rheumatoid arthritis, and 26.6 % OD and 26.3 % OS in ankylosing spondylitis.

Conclusion. The use of SPHERO®oko has been shown to be effective in the treatment of dry eye syndrome in patients with rheumatoid arthritis and ankylosing spondylitis who are receiving gene therapy.

Purpose: to substantiate and present an original combined pharmacological treatment regimen for neurotrophic keratitis aimed at suppressing inflammation, stimulating reparative processes, and forming a stable corneal epithelial layer.

Methods. A pathogenetically substantiated combined treatment regimen for neurotrophic keratitis (NK) was developed. It includes instillations of 0.1 % fluorometholone 4 times daily, 0.1 % cyclosporine once daily, and a combined solution of 0.3 % sodium hyaluronate with 2 % dexpanthenol 3–6 times daily. The mechanisms of action of the regimen components and their effects on the key pathogenetic links of the disease were analysed.

Results. The rationale for each treatment component was substantiated. Fluorometholone suppresses secondary neurogenic inflammation with a minimal risk of complications during long-term use. Cyclosporine exerts anti-inflammatory, neuroprotective, and anti-apoptotic effects, promotes restoration of tear production, and supports epithelial cell viability. The combination of sodium hyaluronate and dexpanthenol provides ocular surface hydration, metabolic support, and stimulation of epithelial cell migration. The combined use of these agents acts on the main pathogenetic mechanisms of NK and provides a synergistic therapeutic effect.

Conclusion. The proposed conservative treatment regimen for NK is aimed at relieving corneal inflammation, stimulating reparative processes, accelerating epithelialisation, and forming a stable epithelial layer. Its use reduces the need for surgical intervention and expands the possibilities of conservative management, primarily in Mackie stage I–II disease.

Purpose: to investigate the biointegration characteristics of orbital implants manufactured from BT-6 titanium powder using Direct Metal Laser Sintering (DMLS) and Electron Beam Melting (EBM) technologies.

Materials and Methods. An experimental study was performed on 20 male chinchilla rabbits. Titanium implants measuring 10´5´2 mm were fabricated from BT-6 titanium powder using DMLS and EBM technologies. The implants were placed into surgically created intermuscular pockets in the dorsal region of the animals. Tissues without implantation served as the control. The observation period was six months. At the end of the study, the implants together with the surrounding tissues were excised and subjected to histological examination. The structure of the connective tissue capsule, vascular component, cellular response, presence of inflammatory changes, and the approximate morphometric thickness of the capsule were evaluated.

Results. No signs of acute or chronic inflammation, microcirculatory disturbances, or pronounced cellular response were observed in any of the examined specimens, indicating good biocompatibility of both implant types. In both groups, a connective tissue capsule formed around the implant bed; however, its morphological characteristics differed. Implants manufactured by the EBM technique were surrounded by a thinner fibrous capsule, whereas implants produced by DMLS demonstrated a thicker capsule with a more pronounced fibrocellular organization. In several specimens, the inner surface of the implant bed was lined by epithelial cells without evidence of atypia or inflammatory reaction.

Conclusion. Orbital implants manufactured from BT-6 titanium powder using DMLS and EBM technologies demonstrated excellent biocompatibility. The observed differences in the morphological organization of the connective tissue capsule suggest that the additive manufacturing technique may influence the tissue integration of titanium implants. These findings warrant further investigation to better understand the relationship between manufacturing technology and the biological response of peri-implant tissues.

Purpose: To assess the technical feasibility and quality of femtosecond radial keratotomy using the Femto LDV Z8 laser system, as well as to determine the biomechanical strength of the cornea under static load in ex vivo experiments.

Material and methods. The study was conducted on cadaveric eyes using the Ziemer Femto LDV Z8 laser system (Switzerland). Individual patterns for dosed corneal incisions were developed, specifically adapted for surgical treatment of progressive keratoconus. Radial incisions were created in the annular zone of the cornea (outer diameter 9–10 mm, inner diameter 3.5–4 mm). Samples were divided into two equal groups: Group 1 (n = 5) — femtosecond radial keratotomy; Group 2 (n = 5) — FS keratotomy followed by ultraviolet corneal collagen crosslinking. To assess the mechanical properties of the cornea, the burst indentation test was used according to GOST 31897 standard, with incremental mechanical loading and fixation of the tissue rupture point. The obtained data enabled comparison of the biomechanical resistance of the cornea after different surgical interventions.

Conclusion. A unique software for the Femto LDV Z8 laser was developed, enabling femtosecond radial keratotomy. The ex vivo results confirmed the technical feasibility of the method and demonstrated that combined intervention (FS-keratotomy followed by UV cross-linking) significantly increases biomechanical strength of the cornea compared to isolated keratotomy, as evidenced by higher rupture load.

Identifying and systematizing risk factors for the development of rhegmatogenous retinal detachment (RRD) remains a key challenge in modern ophthalmology.

The aim of this review is to analyze, summarize, and quantify current data on risk factors for the development of RRD.

Methods. The review included an analysis of Russian- and English-language publications of cohort studies in PubMed, Google Scholar, CyberLeninka, and Elibrary. The protocol was registered on PROSPERO (CRD420251272654).

Results. The initial search strategy and reference list analysis yielded 1,175 publications potentially relevant to the topic of research. After screening for inclusion/non-inclusion criteria and removing duplicates, the final sample for qualitative synthesis included 22 studies. Studies with no restrictions were selected for quantitative synthesis (meta-analysis calculations). Myopia is a dominant predictor of RRD. The presence of myopia increases the risk RRD by 2.98 (95 % CI: 2.95–3.02) times. A change in the spherical equivalent by 1 diopter towards myopia increases the risk RRD by 1.31 (95 % CI: 1.26–1.35) times. Other significant ophthalmologic factors include degenerative changes in the retinal periphery, posterior uveitis (especially of cytomegalovirus and herpes etiology), glaucoma, hypotony, previous eye surgery, and the presence of detachment in the fellow eye. A meta-analysis revealed consistent demographic patterns: the mean age at onset was 56.5 years (95 % CI: 48.08–64.18), with a male predominance (66.6 %, 95 % CI: 56.2–77.0) and right eye involvement (52.0 %, 95 % CI: 50.5–53.4). Male gender increases the OR and risk of RRD by 2.32 (95 % CI: 2.30–2.34) and 2.75 (95 % CI: 2.70–2.74) times, respectively. A significant association was found with comorbid conditions that increase the risk of the disease: inflammatory processes (periodontitis), cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, obesity, and mental disorders. The influence of socioeconomic factors was established: the higher the level of education and income and the more developed the area of residence, the higher the risk. Regular heavy lifting increases the probability of developing RRD.

Conclusion. The findings of the study highlight the need for a comprehensive approach to risk stratification and targeted preventive monitoring of high-risk patients, which is of paramount importance for improving functional outcomes.