Purpose: to study the effectiveness of seydana (black cumin) oil in combined treatment of herpetic endothelial keratitis. Material and methods. The study included 68 patients (68 eyes) with herpetic endothelial keratitis, developed after cataract surgery. 35 men and 33 women aged 39 to 73 (58.3 ± 8.9) years were divided into two equal groups. The main group (34 patients, 34 eyes) received conventional treatment supplemented with black cumin oil, while the comparison group of 34 patients (34 eyes) received conventional treatment alone. Results. Cornea infiltration in the main group resorbed sooner than in the comparison group (18.43 ± 0.3 days and 23.2 ± 0.5 days respectively; p < 0.05). The treatment lasted shorter in the main group compared with the comparison group (22.1 ± 0.1 days vs. 25.2 ± 0.3 days; p < 0.05). Complete epithelialization was averagely noted on the 19th to the 21st day of treatment (respectively, 19.6 ± 0.9 and of 21.12 ± 0.6; p > 0.05). Visual acuity improved to achieve, respectively, 0.51 ± 0.24 and 0.44 ± 0.17 (p > 0.05). Conclusion. The patients who received seydana oil in addition to conventional treatment showed a significantly higher therapeutic effect in some parameters (resorption time of corneal infiltration and duration of treatment) than the comparison group.

Purpose. To find the connection between the parameters of the corneoscleral shell and lamina cribrosa (LC) and hemodynamic parameters of the eyes with primary open angle glaucoma (POAG). Materials and methods. The study involved 111 eyes of 63 patients, including 41 eyes without ophthalmic pathology (control group, mean age M ± SD 66.9 ± 18.2 yrs), 22 eyes with the initial glaucoma stage (group 1, mean age 65.9 ± 11.3 yrs), 31 eyes with the developed glaucoma stage (group 2, mean age 69.2 ± 17.3 yrs), and 17 eyes with the advanced glaucoma stage (group 3, mean age 69,7 ± 7.3 yrs). LC parameters and the density of surface (SVL) and deep (DVL) vascular layers were measured using Spectralis OCT2 with an angiography module (Heidelberg Engineering, Germany) in the enhanced deep imaging (EDI) mode using AngioTool software. Corneal hysteresis (CH) and corneal resistance factor (CRF) were determined using ORA (Ocular Response Analyzer, Reichert, USA). The rigidity coefficient (E) of the corneoscleral shell was measured by a GlauTest-60 tonograph (Russia) operation in the differential tonometry mode. The elasticity coefficient (s) was determined by a modified differential tonometry technique. The rheographic index (RI) and pulse blood volume (PBV) were measured using transpalpebral rheoophthalmography. Results. A statistically significant correlation was revealed between CH and SVL (р = 0.005, r = 0.288), LC thickness and SVL and DVL (р = 0.001, r = 0.374 and р = 0.003, r = 0.397, respectively). A negative statistically significant correlation was found between E and RI (р = 0.000, r = -0.538) as well as between E and PBV (р = 0.001, r = -0.376). A similar correlation was revealed between s and theses parameters (RI and PBV; р = 0.027, r = -0.404 and р = 0.024, r = -0.410, respectively). E increase is accompanied by a decrease in the SVL density (р = 0.000, r = -0.376); besides, PBV is negatively correlated with the LC depth (р = 0.022, r = -0.257). Conclusion. In POAG, deteriorated blood supply of inner ocular shells (decreased RI, PBV, SVL and DVL density) correlates with (a) increased corneoscleral rigidity (manifested in the increase of rigidity and elasticity coefficients, and the decrease of CH), and (b) decreased LC thickness and its increased depth. Increased rigidity of the corneoscleral shell contributes to an LC posterior displacement. It must be concluded that LC thickness is a more sensitive biomechanical parameter that changes even in the initial stages of POAG and has a high diagnostic value.

Prostaglandin analogues (PAs) are the drugs of choice in the treatment of primary open-angle glaucoma (POAG). However, they have pro-inflammatory properties and may cause macular edema. Tafluprost is the first PA to be free of preservatives. The efficacy and safety of tafluprost, as well as that of tafluprost/timolol fixed combination (FC), was demonstrated in randomized multicenter trials. However, there are no literary data concerning the effect of tafluprost and its FC on the thickness of the macula. Purpose. To assess the effect of tafluprost and tafloprost/timolol on the retinal thickness in the macular area in patients with POAG. Material and methods. The retinal thickness (RT) was measured with an interval of a week in 36 patients (36 eyes) with a newly diagnosed initial stage of POAG, 12 of whom were prescribed taflotan, 12 patients received tafluprost/timolol FC, and 12 eyes represented the control group (no drugs were prescribed). The measurements were performed in the macular area using a spectral domain optical coherence tomography (SD-OCT) by means of the RtVue xR Avanti with the AngioVue OCT angiography function. The change in the intraocular pressure (IOP) and RT from the inner limiting membrane (ILM) to the inner plexiform layer (inner retina) and to the pigment epithelium (PE) in fovea and parafovea in total and by sectors were estimated by comparing paired repeated observations using the median growth analysis. Results. In the tafluprost group, a 19.4 % IOP decrease was revealed and in the tafluprost/timolol group the decrease achieved 43 % with respect to the reference level. In patients receiving tafluprost, an increase in the RT in parafovea was noted: median growth 2 μm (p = 0.035); and in patients receiving tafluprost/timolol — in the inner layers of parafovea: median growth 3 μm (p = 0.031), and its inferior half: median growth 2.5 μm (p = 0.023). These changes were obtained in 10 patients out of 12 in each treated group. In untreated patients, the RT remained unchanged. The visual acuity did not change in any group of patients. Conclusions. In patients with glaucoma, a thickening of both the inner layers and the entire macular retina occurred within a week after treating with tafluprost or its FC, leaving no clinical manifestation. This fact should be taken into account in patients likely to develop macular edema.

Purpose: to evaluate subfoveal choroidal thickness (SFCT) and other anatomical parameters of the eye in the early stages after orthokeratological correction of myopia. Material and Methods. The study was conducted on 20 myopic Caucasian patients (40 eyes) with moderate myopia. The main group consisted of 10 children with myopia -4.5 ± 1.03 D aged 11 ± 2.26 years, who were examined before the correction with orthokeratological lenses (OK-lenses) ESA-DL (Dr Lens Tehno, Russia) and 3 weeks after it. The control group comprised 10 patients (20 eyes) with myopia -3.84 ± 1.12 D aged 11.6 ± 1.17 years, who wore monofocal glasses as a correction. SFCT was measured with RS-3000 Advance optical coherent tomograph (OCT) (Nidek, Japan), while axial length (AL), peripheral eye length (PEL), and anterior chamber depth (ACD) was measured with IOL Master 500 optical biometer (Carl Zeiss, Germany), and central cornea thickness (CCT), epithelial thickness (ET) and corneal stroma (ST) thickness, with OCT Avanti Rtvue XR (Optovue, USA). All patients were tested before and 3 weeks after the start of wearing lenses or glasses. Results. SFCF increased by 24.25 ± 19 μm as compared with changes in the control group (p < 0.001) after 3 weeks of wearing OK-lenses. A notable negative correlation of changes in AL and SFCT was revealed in the main group (r = -0.48). CCT decreased by 14.6 ± 2.54 μm in the group wearing OKlenses. The main OK-lens contribution to the statistically significant change in the CCT concerned the epithelium, whose thickness showed a 12.7 ± 1.58 μm (22.6 %) change as compared with the initial data (p < 0.001) and with the change in the control group (p < 0.001). The decrease in AL showed an insignificant correlation with the decrease in the CCT: r = 0.16. ACD, PEL and ST did not change significantly (p > 0.05). Conclusion. SFCT shows an increase in the early stages after OK correction. When controlling the growth of the eye in patients with OK lenses, we need to take into account the impact of the choroid on the results of AL measurement.

Purpose. To study the relationship of biometric parameters, visual acuity, eye refraction and intraocular pressure (IOP) with blood glucose levels and glycated hemoglobin (HbA1c) in patients with subcompensated insulin-requiring type II diabetes mellitus. Material and methods. Ophthalmic monitoring lasted 3 years, the experience of insulin therapy — 6 years. 32 patients (27 women and 5 men) with insulin-requiring diabetes mellitus and no severe general diabetic complications or concomitant eye pathology were monitored for 3 years. The patients’ average age was 60.4 ± 5.3 years; average weight 94.3 ± 16.5 kg; average height 163.4 cm; average BMI (body mass index) was 29.93 kg/m2, all received insulin treatment for 6 years. Patients determined the level of blood glucose themselves on a daily basis using individual “Accu-Check” and/or “OneTouch select” glucometers, supplemented by endocrinologist checks on scheduled examinations once a month. The level of glycated hemoglobin (HbA1c) was determined once every 3–6 months. The 3-year ophthalmic monitoring involved both eyes and included biomicroscopy, autorefractometry, pneumotonometry, measurement of the anterior-posterior axis, the depth of the anterior chamber and lens thickness; pachymetry of the cornea in the central optical zone, and ophthalmoscopy. Visometry was performed according to ETDRS (Early Treatment Diabetic Retinopathy Study Research Group) requirements. Results. The impact of blood glucose level on visual acuity (Spearman R = 0.18/-0.23, t (N-2) = 1.07/-1.34, p = 0.1) is higher than that of HbA1c (Spearman R = 0.07/-0.15, t (N-2) = 0.4/-0.8, p = 0.65) The higher the glucose level, the lower the depth of the anterior chamber and the shorter the APA. In contrast, the higher the level of HbA1c, the thicker the cornea in the central optical zone. Both the glucose and the HbA1c levels reveal a similar positive correlations with IOP. A refraction shift toward myopia from 42 % to 55 % was shown to correlate to HbA1c, and a  corresponding reduction of hyperopia share was revealed. Conclusions. In patients with  subcompensated insulin-requiring diabetes mellitus type II, biometric parameters, refraction and intraocular pressure are determined by changes in the level of blood glycemia. 

Purpose: to describe the characteristic clinical signs and to study the causes of the development of an unfavorable prolonged course of bacterial corneal ulcers of central localization, and to improve treatment effectiveness. Material and methods. A total of 289 patients with central bacterial corneal ulcers were examined. Two types courses of bacterial corneal ulcer were distinguished: favorable (acute and subacute) and unfavorable (prolonged subacute and prolonged chronic forms). Blood (122 samples) and scrapings from corneal ulcers (110 samples) were examined in a nested polymerase chain reaction (PCR) to detect deoxyribonucleic acid (DNA) of simple herpes virus (HSV) 1 and 2 types, virus Epstein–Barr (VEB), human herpes virus (HHV)-6, and HHV-7. To detect autoimmune sensitization to the corneal antigens, migration inhibition reaction of leukocytes (MIRL, 215 samples) was used. Results. In patients with unfavorable course of the disease, blood and corneal HHV DNA was detected in 88.7 % of cases, while with a favorable course only 10 % of cases showed the presence of HHV DNA (р < 0.002). In all patients, HHV type 6 was predominating. Autosensitivity to corneal antigens was detected in 8 (10.4 %) out of 77 patients at the end of the first week of the disease, and as the disease progressed, the number of patients with an autoimmune component increased to reach 63.2 % (48 of 76). The inclusion of antiviral and immunosuppressive drugs into the routine treatment plan led to complete epithelialization of the cornea within 5–10 days. Сonclusion. The protracted course of bacterial corneal ulcers was found to be caused by a mixed herpes-bacterial infection, which is corroborated by the effectiveness of the modified treatment tactics.

The effect of pseudoexfoliation syndrome (PEХ) on endothelial cells has been studied long enough. Yet the effect of phacoemulsification (PHACO) on endothelium in patients with PEХ is less explored. Purpose. To assess the impact of PHACO on corneal endothelial cell density (ECD) and on the coefficient of variation (CV) in patients with PEX. Material and methods. 30 patients (30 eyes) with PEX syndrome and 34 patients (34 eyes) with no such syndrome were examined before and after phacoemulsification. Results. In patients with PEX, the ECD after PHACO was significantly lower and CV was significantly higher (р < 0.05). Conclusion. PEX has a negative impact on endothelial cells, which leads to a pronounced cells loss after PHACO.

Purpose: to investigate the choroidal and retinal morphology in Huntington's disease (HD) using optical coherence tomography (OCT) and to analyze how the parameters studied correlate with the clinical data. Material and methods. The study included two groups of subjects, (1) 44 HD patients, averagely aged 37.6 ± 10.2 yrs, and (2) 31 healthy volunteers, averagely aged 37.3 ± 10.8 yrs. The groups had matching age, sex distribution, intraocular pressure and mean refractive error. In the study group, 21 patients had pre-manifest and 23, manifest HD stage. All patients underwent a thorough neurological and ophthalmic examination which included retinal OCT. The foveal choroidal thickness, retinal thickness in 9 areas of the macular zone, retinal ganglion cells complex (GCC) and peripapillary retinal nerve fiber layer thickness (RNFL) were evaluated in 4 quadrants. CAG repeat expansion size (cytosine-adenine-guanine) in the huntingtin gene, the disease duration and Unified HD Rating Scale motor scores (UHDRS) were evaluated for HD patients. Results. The range of the CAG repeat expansion size in the study group was 37–56 repeats (44.3 ± 3.8), the UHDRS motor score was 36.3 ± 29.7, disease duration was 13.7 ± 7.2 years. OCT revealed a significant decrease in the foveal choroidal thickness, GCC complex thickness, average, temporal, inferior and nasal RNFL thickness and total retinal thickness in the external temporal area in HD patients as compared to the controls. In addition, an inverse correlation between the disease duration, UHDRS Motor Score and a number of OCT parameters was found. Conclusion. The results confirm the promising potential of retinal tomographic parameters as a biomarker for early diagnosis and monitoring of the neurodegenerative process progression. The topography of retinal thickness reduction indicates a specific pattern of retinal neurodegeneration in HD. 

Purpose: to study the dynamic refraction of myopic eyes at the time when the object is fixed in an open field at a distance of 5 m and determine habitual accommodation tone (HAT) in an open field. Material and methods. 130 patients (260 eyes) aged 6 to 23 years (ave. 11.26 ± 0.2 years) with an average refraction spherical equivalent of -4.16 ± 0.13 D were divided into 4 groups, depending on the degree of myopia. The HAT was measured by an automatic binocular open field (OP) autorefkeratometer Grand Seiko WR-5100K (Japan), while the HAT according to Yuri Rosenblum was determined by a conventional autorefractometer Nidek. Results. Comparing noncycloplegic and cycloplegic refraction using the two devices, we obtained different results. In the first case, we found the maximal difference of -0.15 D (-4.38 – (-4.23)), and in the second case, the minimal difference of -0.09 D (-4.16 – (-4.07)). Over the whole group, HAT according to Yuri Rosenblum averaged -0.21 ± 0.02 D. In patients with low myopia HAT was the highest and averaged -0.33 ± 0.03 D. In patients with moderate myopia an average HAT level was -0.23 ± 0.03, and in high myopia it was -0.19 ± 0.04 D. Patients with anisomyopia showed a significant difference of the tone between the fellow eyes: the eyes with lower refraction showed a HAT of -0.21 ± 0.03 D, while for the worse eye it was 0.06 ± 0,11 D (p < 0.05) (i.e. a negative accommodation tone). Over the whole contingent HAT OP averaged -0.17 ± 0.02 D: in patients with low myopia it averaged -0.22 ± 0.04 D, in those with moderate myopia, -0.27 ± 0.02 D, in high myopia — -0.09 ± 0.04 D. PTA OP patients with anisomyopia averaged -0.07 ± 0.03 D and demonstrated a significant difference between the eyes (-0.26 ± 0.03 D for the better eyes and 0.12±0.06 D — for the worse eyes, p < 0.01). A negative tone of accommodation of HAT OP in myopia occurs, on average, in 30% of patients; the frequency was maximal in high myopia (50 %) and minimal in moderate myopia (13.8 %). Conclusions. Objectively determined the weakening of the far dynamic refraction as compared with the static refraction (in terms of cycloplegia) was objectively determined. Thus, the existence of negative accommodation was confirmed. 

Purpose: to study eye hydrodynamics in children subjected to total intravenous anesthesia during ophthalmic operations. Materials and methods. 50 children (100 eyes) aged 15 days to 14 years were examined. 21 children showed impaired hydrodynamics while the remaining 29 had no hydrodynamic disorders. All patients received combined endotracheal anesthesia for ophthalmic operations. Results. The patients with undisturbed hydrodynamics showed a significant increase in true intraocular pressure (Po) (by 3.8 ± 0.12 mm Hg) after an injection of anesthesia with ketamine, due to a significant increase in aqueous humor production. Children with disturbed hydrodynamics, who received an antihypertensive ophthalmic drug (arutimol 0.25–0.5 %), after an injection of anesthesia with fentanyl, showed a significant Po decrease (by 3.9 ± 0.12 mm Hg) due to a significant increase of outflow facility rate (C) and a decrease in aqueous humour volume (F). The patients who received no antihypertensive therapy showed a significant decrease in Po (by 2.08 ± 0.7 mm Hg) due to a significant increase in C. In contrast, the decrease in F proved to be insignificant. Conclusion. For an objective assessment of tonographic  parameters in children with impaired eye hydrodynamics who received antihypertensive therapy (arutimol 0.25–0.5 %) and anesthesized with fentanyl, we recommend that the Po indices be adjusted  upwards by 3.9 ± 0.12 mm Hg, without arutimol by 2.08 ± 0.7 mm Hg, which will help in choosing the type and volume of antiglaucomatous operations. It is also necessary to take into account the increase in Po under the action of ketamine (by 3.8 ± 0.12 mm Hg) in children with undisturbed eye hydrodynamics to prevent possible intra- and postoperative complications.

Purpose. To study and classify artifacts of spectral-domain optical coherence tomography (OCT).  Material and methods. The retrospective study included OCT data of 112 patients (112 eyes)  examined on two Cirrus HD-OCTs (Carl Zeiss Meditec) sequentially for three days (macular area examinations, 67 patients) and five days (examination of the optic disc region, 62 people), including 17 people who underwent both types of examination. Both the original scanning data (B-scans) and the results of their subsequent analysis were evaluated for the presence of artifacts. Results. The criteria of OCT artifacts were suggested and their practical classification was proposed, which distinguishes three types of artifacts: segmentation errors/errors in delineation of the optic disc borders, "out-of-register" artifacts and displacement/fallout of B-scans, and eight main causes of artifacts. The frequency of artifacts ranged from 19 % (analysis of the optic disc area) to 37 % (analysis of the macular area) and 65 % (evaluation of the ganglion cell-inner plexiform layer). The most common were segmentation errors in patients with pronounced pathology or epiretinal membranes (fibrosis). Conclusion. Clinically significant OCT artifacts occur in 19–65 % of cases, depending on the analyzed eye fundus structures. The most common artifacts are segmentation errors in patients with pronounced pathology and epiretinal membranes (fibrosis). A practical classification of OCT artifacts is proposed, which distinguishes three main types and the most important causes of their presence.

Purpose: to assess the changes in visual functions in patients with age related macular degeneration (AMD) and medium to high degree myopia treated with a peptide bioregulator and a multivitamin complex. Material and methods. 60 patients (120 eyes) aged 44 to 79 with age-related changes in the retina treated with peptide bioregulator and/or multivitamin complex were tested for changes of visual functions. The patients, examined before and after treatment with both, were divided into 2 groups depending on treatment type (peptide plus multivitamin vs. multivitamin alone), which were further subdivided into two subgroups depending on the axial length of the eyeball (less than 26.5 mm vs. 26.5 mm or more). Results. A positive response to the therapy (increased visual acuity and improved perimetic parameters) was revealed in patients of both groups with AL < 26.5 mm), which may be accounted for by an initially better state of the retina. The patients of the subgroup with AL  26.5 mm) showed a significant improvement of uncorrected visual acuity, but best corrected visual acuity remained practically the same. Conclusions. The proposed treatment with a polypeptide bioregulator in combination with a multivitamin complex can be used in AMD and myopic patients with retinal pathology.

Purpose: to design methods and algorithms of technical means selection for near visual work in low vision patients. We propose tables to measure near vision acuity ranging from 0.01 to 0.8, with test character sizes varying in logarithmic progression with 1.26 denominator. The tables help determine the minimal size of readable font = the reading threshold and magnification degree needed to ensure the reading of a normal font. To choose the optimal magnifier, a quantitative criterion was chosen — the reading rate. Due to these methods we were able to recommend the most effective technical means of rehabilitation for monocular or binocular use depending on the reading threshold, reading rate, the presence of ophthalmic pathologies and the patient’s age. 

We present two clinical cases of conjunctival lymphoma, the disease which is classified as a malignant tumor of the eye. Conjunctival lymphoma has systemic involvement. Patients presented in our monitoring study received a conservative treatment for chronic conjunctivitis over a long period of time. The article considers the diagnostics and treatment plan of lymphoproliferative eye disease, which allows an increased effectiveness of treating.

Purpose: to present a clinical case of retinal abiotrophy in mitochondrial pathology (NARP syndrome) caused by the mutation m.8993T>G in the ATPase gene type 6 in order to improve the diagnosis of hereditary abiotrophies. Material and methods. The results of a clinical molecular genetic examination of the patient’s family, undertaken in order to clarify the diagnosis and determine the genetic risk, are presented. The family was found to have an isolated pathology of the eye. Results. DNA studies by MLPA method and the analysis of clinical data in the family revealed a hereditary syndromic pathology which caused changes in the eyes. The inheritance type was found to be maternal. Conclusion. NARP syndrome 
is a syndrome with the maternal type of inheritance in which retinal abiotrophy is primarily associated with the mutation m.8993T>G mtDNA and can be considered as the main diagnostic feature among other clinical manifestations. The case demonstrates the difficulties of diagnosing hereditary syndromes accompanied by eye pathology.

The review is focused on the modern view of the etiology and pathogenesis of limbal stem cells deficiency. The history of development of tissue and ex-vivo transplantation of limbal epithelial stem cells is presented. Certain promising directions of the treatment of patients with limbal stem cells deficiency are presented.