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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">helmholtzeyeinstitute</journal-id><journal-title-group><journal-title xml:lang="ru">Российский офтальмологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Ophthalmological Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-0076</issn><issn pub-type="epub">2587-5760</issn><publisher><publisher-name>Real time Publishers</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21516/2072-0076-2020-13-4-7-16</article-id><article-id custom-type="elpub" pub-id-type="custom">helmholtzeyeinstitute-514</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СТАТЬЯ НОМЕРА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LEADING ARTICLE</subject></subj-group></article-categories><title-group><article-title>Стратегически ориентированная концепция оптической профилактики возникновения и прогрессирования миопии</article-title><trans-title-group xml:lang="en"><trans-title>A strategically oriented conception of optical prevention of myopia onset and progression</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарутта</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarutta</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елена Петровна Тарутта — д-р мед. наук, профессор, начальник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Еlena P. Tarutta — Dr. of Med. Sci., professor, head of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Проскурина</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Proskurina</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ольга Владимировна Проскурина —д-р мед. наук, ведущий научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Olga V. Proskurina — Dr. of Med. Sci., leading researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><email xlink:type="simple">proskourina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маркосян</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Markossian</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гаяне Айказовна Маркосян — д-р мед. наук, ведущий научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Gayane A. Markossian — Dr. of Med. Sci., leading researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Милаш</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Milash</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Викторович Милаш — научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Sergey V. Milash — researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарасова</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarasova</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наталья Алексеевна Тарасова — канд. мед. наук, старший научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Natal'ya A. Tarasova — Cand. of Med. Sci., senior researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ходжабекян</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Khodzhabekyan</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Нарине Володяевна Ходжабекян — канд. мед. наук, ведущий научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики</p><p>ул. Садовая-Черногрязская, д. 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Narine V. Khodzhabekyan — Cand. of Med. Sci., leading researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics</p><p>14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Helmholtz National Medical Research Center of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>16</day><month>12</month><year>2020</year></pub-date><volume>13</volume><issue>4</issue><fpage>7</fpage><lpage>16</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тарутта Е.П., Проскурина О.В., Маркосян Г.А., Милаш С.В., Тарасова Н.А., Ходжабекян Н.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Тарутта Е.П., Проскурина О.В., Маркосян Г.А., Милаш С.В., Тарасова Н.А., Ходжабекян Н.В.</copyright-holder><copyright-holder xml:lang="en">Tarutta E.P., Proskurina O.V., Markossian G.A., Milash S.V., Tarasova N.A., Khodzhabekyan N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://roj.igb.ru/jour/article/view/514">https://roj.igb.ru/jour/article/view/514</self-uri><abstract><p>Представлено теоретическое и клиническое обоснование применения оптических средств профилактики миопии. Аккомодация, аберрации волнового фронта, периферическая рефракция и качество ретинального изображения рассматриваются как связанные между собой факторы, влияющие на постнатальный рефрактогенез. Проведен подробный анализ способов коррекции миопии и состояний, предшествующих ее развитию, и их влияния на динамику рефракции и рост глаза. Предложена стратегия оптической коррекции миопии, включающая: 1) для детей группы риска в возрасте 4–7 лет — постоянное ношение дефокусирующих плюсовых очков в бинокулярном формате или (в случае экзофории) — очков Perifocal-P; 2) при миопии от 0,5 до 2,75 дптр, орто- или эзофории, умеренно сниженных запасах относительной аккомодации (ЗОА), периферической миопии или эмметропии — постоянную альтернирующую слабомиопическую дефокусировку, при ЗОА менее 1,0 дптр — прогрессивные очки, в случае сочетания сниженных ЗОА и экзофории — очки Perifocal-Msa; 3) при миопии любой степени с уже имеющимся гиперметропическим периферическим дефокусом — очки Perifocal-М, при ЗОА менее 1,0 дптр в сочетании с эзофорией — прогрессивные очки, в сочетании с экзофорией — очки Perifocal-Msa; 4) при отказе от очковой коррекции — контактную коррекцию бифокальными мягкими контактными линзами (МКЛ) или ортокератологическими контактными линзами (ОКЛ), при миопии средней и высокой степени предпочтительны ОКЛ; 5) при миопии свыше 8,0 дптр, миопии с астигматизмом — биоптическую коррекцию: сочетание монофокальных МКЛ и очков Perifocal-М для исправления периферического дефокуса и остаточного астигматизма.</p></abstract><trans-abstract xml:lang="en"><p>The article presents a theoretical and clinical justification for optical techniques used for the prevention of myopia. Accommodation, wavefront aberrations, peripheral refraction, and retinal image quality are considered as interrelated factors affecting postnatal refractogenesis. A detailed analysis of myopia correction methods, conditions preceding its development and their impact on the dynamics of refraction and eye growth is given. A strategy of optical correction of myopia was proposed, which includes: 1) constant wearing of defocusing binocular positive spectacle lens or Perifocal-P spectacle lens (in case of exophoria) for children at risk aged 4–7 years; 2) constant alternating weak myopic defocusing in case of myopia from 0.5 to 2.75 D, ortho- or esophoria, positive relative accommodation (PRA), peripheral myopia or emmetropia; progressive addition spectacle lens in case of PRA less than 1.0 D; Perifocal-Msa spectacle lens in the case of a combination of reduced PRA and exophoria; 3) Perifocal-M spectacle lens in case of myopia of any degree with already existing hyperopic peripheral defocus; progressive addition spectacle lens in case of PRA less than 1.0 D in combination with esophoria or Perifocal-Msa spectacle lens in combination with exophoria; 4) contact correction with bifocal soft contact lenses or orthokeratological contact lenses (Ortho-K) in case of refusal from spectacle correction. Ortho-K is preferable with moderate and high myopia; 5) bioptic correction: a combination of monofocal soft contact lenses and Perifocal-M spectacle lens to correct peripheral defocus and residual astigmatism is preferable for myopia over 8.0 D and myopia with astigmatism.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>миопия у детей</kwd><kwd>контроль миопии</kwd><kwd>коррекция миопии</kwd><kwd>прогрессирующая миопия</kwd><kwd>периферическая рефракция</kwd><kwd>миопический дефокус</kwd></kwd-group><kwd-group xml:lang="en"><kwd>childhood myopia</kwd><kwd>myopia control</kwd><kwd>myopia correction</kwd><kwd>myopia progression</kwd><kwd>peripheral refraction</kwd><kwd>myopic defocus</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Fricke T.R., Jong M., Naidoo K.S., et al. 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