Purpose: to study the role of cellular immunity in the development of retinopathy of prematurity (ROP).

Material and methods. 87 children were tested, including 60 with III — V stage ROP and posterior aggressive retinopathy that had gestational age from 25 to 32 weeks at birth, aged 1 month to 1 year (study group) and 27 healthy children of the same age (control group).

Results. No statistically significant differences of immunological parameters were revealed within the groups of children aged 1 to 3 months, 3.5 to 6 months, and 6.5 to 12 months. The gestational age at birth had no effect on the parameters studied. With increasing severity of ROP amid reduced indicators of T-regulatory cells, the number of B-cells (CD19 +) grew, T-natural killer cells (CD3 -/CD16 +CD56 +) reduced significantly (p < 0.05), and the number of CD4+ T-cells reduced showing the significance of (p < 0.01–0.05).

Conclusion. The obtained data testify to the emergence of autoimmune reactions and a decrease in the level of regulatory T-cells in a premature child, more pronounced in severe stages of ROP.

Purpose. To study tonometry parameters features, measured by different methods, taking into account individual morphometric eye parameters and biomechanical properties of the corneoscleral shell in patients with the initial and the advanced stages of primary open angle glaucoma (POAG).

Material and methods. 51 patients (99 eyes) aged 48–82, with the initial (45 eyes) and advanced stages (54 eyes) of POAG were examined. The control group consisted of 31 patients (62 eyes) aged 47–83 without ophthalmic pathology. In addition to standard ophthalmologic examination, tonometry was performed using the Ocular Response Analyzer (ORA, Reichert Inc., the USA).

Results. The main tonometry parameters of ORA revealed significant differences between POAG patients and the control group. No significant difference in the central corneal thickness (CCT) was found between the POAG and the control group. Patients with I and II stages of glaucoma taken separately showed differences in CCT and tonometry parameters.

Conclusion. Dynamic bi-directional applanation tonometry enables to take into account the changes in viscoelastic properties of the corneoscleral eye shell, and definitely has diagnostic advantages in examining patients with various stages of POAG.

Purpose. To present the preliminary results of iridocapsular fixation of RSP-3 extracapsular IOL in patients with lens subluxation observed within the first year after surgery.

Material and methods. 4 patients with cataracts and initial weakness of Zinn ligament fibers were followed up. YAG laser iridectomy was performed one day before facoemulsifcation surgery, which took account of Zinn ligament fiber weakness: it consisted in anterior continuous circular capsulorhexis with a diameter of about 5 mm, fixation of the capsular bag over the edge of capsulorhexis with four iris-capsular retractors (ICRs), phacoemulsification of the nucleus and aspiration of lens masses. The intracapsular ring and the RSP-3 IOL (the latter in the injector through the main incision) was implanted in such a way as to locate the rear support element in the capsular bag, and the front support element, in front of the pupil. After removing the ICRs, iridectomy was monitored.

Results. The early postoperative period was uncomplicated. After 10 days, one patient was found to develop a relative pupillary block with the anterior chamber becoming shallower and IOP increased to reach 28 mm Hg. The reason was that iridectomy initially located in the projection area of the rear support element. An additional iridectomy arrested the situation. Visual acuity varied from 0.3 to 1.0 due to the initial state of the optic nerve and retina. The position of the IOL remained stable throughout the year, the capsular bag was unfolded.

Conclusion. The possibility to use the capsular bag of the lens under the conditions that Zinn ligament fibers are weak should be considered as an advantage of the technology presented. An additional front support element serves to prevent dislocation of the IOL and the capsular bag as a whole. The obtained positive results of combined iridocapsular fixation of the IOL justify a more extensive clinical testing of the method in cases of weak Zinn ligament fibers.

The aim of the work is to develop a differentiated method of surgical treatment of children with congenital ectopia of the lens using a capsule ring and intra — capsule fixation of IOL.

Material and methods. 15 children (28 eyes) at the age of 5–8 years with congenital ectopic lens I–III degree with the syndrome of Marfan, Weil — Marchesani, homocystinuria and isolated pathology were operated. The lens was removed after the introduction of the capsular ring by the method of phakoaspiration and aspiration — irrigation using viscoelastics. One-pieces models of the Acrysof IOL SN60AT and Hoya iSert model 251 were implanted. Anterior capsulorhexis was performed manually (сystotomy, needle, collet tools) and/or using an YAG laser. After hydrodissection of the lens masses, the ring was injected in the capsular bag using the injector, and then removed the lens masses and implanted a one-piece IOL.

Results. The technique of performing individual stages was determined by the lens ectopia degree. At I–II degree of ectopia, manual or YAG-laser circular anterior capsulorhexis was performed. Limited anterior vitrectomy was performed in the zone of lens displacement at the III degree of ectopia and the presence of vitreous body. Visual acuity before surgery was from 0.04 to 0.1–0.15, after surgery — 0.1–0.15 — 0.6.

Conclusion. The use of differentiated methods of different stages of surgery and the intra — capsule ring in congenital ectopia of the lens allows intra-capsular IOL implantation with high functional and anatomical results at a low level of intra-and postoperative complications.

Purpose. To evaluate the effectiveness and the factors predictive of long-term failure of selective laser trabeculoplasty (SLT) in patients with the initial stage of primary angle-closure (PACG) and primary open angle glaucoma (POAG).

Materials and methods. 65 PACG patients (65 eyes) and 65 POAG patients (65 eyes) were observed for 6 years. SLT was considered to be successful if its hypotensive effect consisted in an IOP decrease ³ 20 % achieved without any additional hypotensive treatment by antiglaucoma drop instillations or any hypotensive intervention (repeated SLT, antiglaucoma surgery, cataract phacoemulsification). The effectiveness was assessed using the Kaplan — Meier survival analysis. To determine the factors predictive of SLT, one-factor Cox proportional hazards regression analysis was used. Results. The hypotensive effect of SLT achieved was, for PACG and POAG, respectively, (1) 82 and 84 % one year after surgery; (2) 62 and 68 % two years thereafter, (3) 59 and 63 %, three years thereafter, (4) 34 and 42 %, four years thereafter, (5) 26 and 38 %, five years thereafter, (6) 4 and 8 % thereafter (log rank test, p = 0.234). The predictors of SLT failure were common for both forms of glaucoma in Cox regression analysis, namely: initial IOP > 24 mm Hg (OR = 1.184, p = 0.029 for PACG and OR = 1.156, p = 0.010 for POAG), corneal hysteresis < 9,5 mm Hg (OR = 1.441, р = 0.022 for PACG and OR = 1.486, р = 0.030 for POAG), corneal thickness < 540 μm (OR = 1.586, р=0.021 for PACG and OR =1.648, p =0.030 for POAG), reduced thickness of the retinal nerve fiber layer < 90 μm (OR = 1.231, p = 0.014 for PACG and OR =1.194, p = 0.027 for POAG) and age > 68 years (OR = 1.162, p = 0.040 for PACG and OR = 1.167, p = 0.000 for POAG). The additional failure predictors for PACG were the span of exposure to SLT < 180 0 (OR = 1.686, p = 0.004) and lens thickness > 4.86 mm (OR = 4.841, p = 0.001). Hypertension, diabetes mellitus, trabecular pigmentation degree and the type of antiglaucoma drugs taken before SLT were not found to be significant predictors of SLT effectiveness.

Conclusion. SLT is an effective method of treating initial POAG and PACG after laser iridotomy. The long-term effect of SLT in both forms of glaucoma is affected by the initial IOP, glaucoma stage, and the patient’s age. The most important role in PACG is played by the span of SLT exposure and the size of the lens..

Purpose. To propose the major differential diagnostic criteria of retinal capillary hemangioma (RCH) and vasoproliferative tumor (VPT) aimed at increasing the efficiency of the diagnosis of these diseases.

Material and methods. A comprehensive ophthalmologic examination off 19 (26 eyes) patients, aged 19 to 66 (ave. 31.89 ± 11.30 yrs), with vascular neoplasms of peripheral localization included, beside the standard techniques, fundus photoregistration, fluorescent angiography (FAG), optical coherence tomography of the retina and a combined ultrasound testing using B scanning, echographic densitometry, colour Doppler imaging (CDI), and pulse Doppler imaging.

Results. Based on the analysis of the clinical picture and the results of the tests performed, the following differential diagnostic criteria were proposed: the age at which RCH and VPT developed, their localization in the eye fundus, and the value of the maximal systolic blood flow velocity in the central vein of the retina.

Conclusion. Differential diagnostics of RCH and VPT requires combined approaches and should take into account, in addition to case history and the clinical picture, also the results of instrumental testing techniques: FAG, echography and CDI.

The paper is aimed at comparing the level of aberrations, structure of the wavefront, and its response to cycloplegia in children with different refractions before they started practicing badminton regularly and after a year’s duration of this practice.

Material and methods. 40 children (80 eyes) with refractive errors from +6.63 to -6.75 D (average -1.28 ± 2.28 D) aged 7 to 11 years (average 9.24 ± 1.06 years) were examined before the practice, 6 months after practice start (38 children, 72 eyes) and after 1 year of badminton playing (27 children, 54 eyes). All patients underwent wavefront aberrometry before and after cycloplegia on an OPD-Scan III (Nidek) aberrometer. We analyzed Zernike coefficients up to the 12th order inclusive: vertical and horizontal slope (tilt 1, tilt 2), vertical and horizontal trefoil (trefoil 6, trefoil 9), vertical and horizontal coma (coma 7, coma 8), spherical aberration (SA), mean square deviation from the ideal wavefront (RMS).

Results. SA in myopia was found to be negative, in hyperopia positive; tilt 1, tilt 2, trefoil 9, coma 7 in myopia were significantly higher, and coma 8 significantly lower than in hyperopia. The slope of the wavefront (tilt 1, tilt 2) in cycloplegia falls significantly in hyperopic eyes and does not change in myopic ones. The latter fact points to insufficient tension of Zinn ligaments in the myopic eye. Regular badminton practice results in significant changes in wavefront aberrations, indicating a strengthening of the ligaments of the lens and the normalization of the ciliary muscle tone.

Conclusions. The structure of the wavefront in children with different refractions shows significant differences. Badminton helps strengthen the ligaments of the lens.

Purpose: to evaluate long term effectiveness of a method of restoring the accommodation function of the eye and preventing the onset and progression of myopia and to propose ways to overcome medical requirements that are difficult to meet.

Material and methods. The method consisted in prolonged installations of 1 % tropicamide eye drops and permanent optical correction that corresponded to manifest refraction. 48 schoolchildren aged 7–18 with initial myopia or signs of high risk myopia onset were followed up. The subjects were divided into 2 groups of 24 people each. Group 1 consisted of children who followed medical prescriptions and group 2 consisted of those who did not. The two groups were further subdivided into two subgroups. Subgroup 1A included 12 children with the initial positive cycloplegic refraction up to +1.0 D; subgroup 1B included 12 children with the initial negative cycloplegic refraction from -0.5 D. Subgroup 2A (12 children) had negative cycloplegic refraction who regularly failed to receive treatment (optical correction, eyedrop instillations, medical checkups), and subgroup 2B (12 children) had negative cycloplegic refraction who received practically no treatment for myopia. Regular checkups took place 2–3 times a year for 10 years and included measuring visual acuity, manifest and cycloplegic refraction by skiascopy or subjectively, as well as measuring relative accommodation reserve (RAR) according to the author’s own technique. The treatment envisaged permanent optical correction in accordance with manifest refraction until the age of 18 years, combined with courses of tropicamide 1 % instillations for 1 to 3 months two to three times a year.

Results. In group 1A, myopia was prevented in all subjects. In group 1B, the progression stopped after several years of treatment. In subgroup 2A and especially subgroup 2B, myopia progressed, over the 10-year follow-up period reaching the figures of 2.5 and 3.5 D, respectively.

Conclusion. The long-term efficiency of the proposed method applied to schoolchildren from grade 1 to grade 10 was confirmed. Ways to overcome the difficulties of following medical requirements were proposed.

The article deals with the features of visual disturbances in patient with primary progressive type of multiple sclerosis (MS). On the basis of clinical observations, it was found that, in contrast to the relapsing-remitting type of MS, the visual disturbances are accompanied by a rapidly progressive decrease in visual and oculomotor functions. The process of development of descending partial atrophy of the optic nerve with primary progressive type of MS is symmetric, in contrast to the relapsing-remitting type of the course of MS and is determined by the increase in the severity of brain structures atrophy according to MRI.

A clinical case of excimer laser correction performed by sub-Bowman femtosecond keratomileusis at the peak of botulinum toxin A effect in a patient with high congenital anisometropic myopia and horizontal nystagmus is presented. Keratorefractive surgery improved functional visual performance and the parameters of nystagmus.

The review is focused on modern methods of instrumental diagnostics of primary open-angle glaucoma. Diagnostic possibilities and informativeness of objective measurable parameters are discussed with regard to special criteria, called clinical endpoints.

Ocular targeted drug delivery is one of the most challenging tasks for pharmaceutical researchers and practical ophthalmologists. The possibilities of drug delivery to the eye are naturally determined by the anatomical structure of the eye and its physiological properties, which restrict the period when therapeutically required drug concentration could be maintained. Combined drug delivery schemes may, potentially, improve the patient’s acceptance of treatment, reduce side effects, increase efficacy, and eventually preserve vision.

Antivasoproliferative therapy is a revolutionary trend in the treatment of neovascular age-related macular degeneration (nAMD), as it is aimed at blocking growth factors of the newly formed vessels. Currently, two anti-VEGF drugs are registered for ophthalmological use, and the search for new molecules is only gaining momentum. Studying new approaches to treatment and developing innovative drugs, modern medicine relies on the data from international randomized clinical trials (RCT). The fact that this direction attracts much scientific interest is explained by high reliability of the data obtained with RCTs. However, when analyzing the effectiveness of anti-VEGF therapy in patients with nAMD in routine clinical practice, many ophthalmologists are confronted with discrepancies between the expected morphological and functional results as predicted by RCTs and those obtained in reality. It is thus important to bear in mind that RCTs simply determine how the dynamics of morphofunctional parameters should look like, whilst the ideal result is only achievable through correct implementation of therapeutic strategy in real clinical practice. The results obtained in the practice of any specialist wholly depend on how carefully the prescribed treatment protocols are followed by doctors and patients, how burdensome the treatment is, as well as on the potential of the medication. This literary review offers a comparative analysis of the results achieved by using anti-VEGF drugs (ranibizumab and aflibercept) obtained in key RCTs and in routine clinical treatment of nAMD patients.

Issues of safety and efficacy of drugs attracts much attention worldwide. The growing use of generics and the lack of stringent requirements to research focused on their biological and therapeutic equivalence are causing concern of ophthalmologists. The literary review presents hypotensive properties and physical characteristics of the major original and generic hypotensive eye drops.