The purpose of the study was to find out how age-related macular degeneration and medium-high degree myopia affect the structural and anatomical parameters of the eyeball, and to find whether a relationship exists between various types of myopic staphylomas and changes of visual functions.

Material and methods. 120 patients (236 eyes), with medium and high degree myopia and age-related retinal changes, aged 44 to 81 years were tested for two groups of parameters: quantitative and qualitative. The former included the patients’ age, best corrected visual acuity (BCVA), computer perimetry data, the axial length, and the thickness of the retina in the central zone. The latter included retinal changes, in particular pigment epithelium (PE) defects, drusen, PE detachment, choroidal neovascular membrane (CNV), Fuchs spot and diffuse chorioretinal atrophy. The impact of various types of staphylomas on visual functions was evaluated.

Results. Visual functions were found to directly depend on retinal PE integrity. If defects, detachment, or drusen are present, computer perimetry parameters and BVCA are reducing. Fuchs spot presence and diffuse chorioretinal atrophy reduces BCVA and causes an MD decrease. The lowest visual acuity and considerable light sensitivity loss was noted in patients with combined staphylomas.

Conclusion. The obtained data confirm that retinal dystrophic processes directly affect visual functions: BCVA and retinal photosensitivity levels drop in all retinal changes studied. The presence of staphyloma, being a factor that aggravates myopia, undoubtedly worsens the most of the parameters studied. 

Purpose: to study the relationship of accommodative (objective) and subjective criteria of different types of accommodation disorders.

Material and methods. 62 patients (124 eyes) with myopic refraction, aged 10 to 18, were divided into 6 groups according to accommodation disorders types. All patients were tested objectively on a Speedy-i accommodograph, which determined the coefficient of accommodation response (CAR) and the coefficient of microfluctuations (CMF) and underwent MEM retinoscopy to determine the accommodation response. In addition, subjective methods were used to determine the amplitude of accommodation (by proximetry) and accommodation flexibility (by ±2 D flipper).

Results. A rather close correlation was revealed between the accommodative and subjective evaluation criteria of ciliary muscle performance. Therefore, both the CAR and proximetry data may be used to determine accommodation amplitude. The power of accommodation response may be determined by CAR and MEM retinoscopy, while the accommodation state may be tested by CMF or accommodation flexibility.

Conclusion. A statistically significant correlation between accommodative coefficients and the results of subjective tests enable the practitioners of outpatient care to use the available subjective methods of accommodation disorder diagnosis and, accordingly, determine the best suited optical correction and choose adequate methods of treatment of accommodation disorders.

Purpose. To study the association of mutations and polymorphic variants of the VHL gene with the clinical characteristics of retinal capillary hemangioma.

Material and methods. 29 DNA samples isolated from peripheral blood leukocytes of patients with retinal capillary hemangiomas were tested. The analysis of mutations and polymorphic markers of the VHL gene was carried out by high resolution melting curve analysis.

Results. A significant correlation was found between the frequency of tyrosine mutation in the 156th position of the VHL gene and the localization of the capillary hemangioma in the middle periphery of the fundus, the presence of local exudative retinal detachment and fibroglial proliferation in the tumor region (p = 0.02; RR = 1.86). An association was established between arginine mutation frequency in the 200th position of the gene with the presence of cerebellar hemangioblastoma and spinal cord. A statistically significant association of the GA genotype of the polymorphic marker rs779805 of the VHL gene with the localization of capillary hemangioma in the middle periphery of the fundus was established (p = 0.03; RR = 4.8). It has been shown that the carriage of the T allele of the polymorphic marker rs779808 may be associated with the characteristic localization of the tumor at the extreme periphery of the retina in the upper temporal quadrant. A tendency to increasing frequency of occurrence of the AC genotype of the polymorphic marker rs1678607 in patients with hemorrhagic complications of capillary hemangioma, as well as to increasing frequency of the TT genotype of the polymorphic marker rs1642742 in patients with cerebellar hemangioblastomas was determined.

Conclusion. Further research involving more clinical material is needed, as our results may be important for early diagnosis of Hippel — Lindau disease, prediction of the onset and clinical course of retinal capillary hemangiomas, as well as of the probability of systemic manifestations of the disease. 

The purpose was to study the prevalence of metastasis of choroidal melanoma (CM) and clinical and instrumental criteria of the risk of such metastasis.

Material and methods. A detailed analysis of clinical material for the period of 2000–2018 is presented, involving 304 patients with CM under continuous observation by an ophthalmic oncology center of a multidisciplinary cancer institution.

Results. Metastatic lesion of various organs was diagnosed in 66 (21.7 %) patients. The average age of patients at the time of metastatic lesion verification was 55.65 ± 13.4 years, with the number of women patients prevailing (36 patients out of 66, or 54.5 %). Liver metastases were found in 63.6 %, lungs metastases, 4.5 %, multiple metastases — 31.9 % of patients. With regular follow-up, the critical period for metastasis detection was between one to five years — 77.2 % of patients with metastatic lesions and 16.8 % of the total number of the treated patients. The average time of metastasis appearance after the liquidation treatment was 27.75 ± 22.06 months, in cases of organ preservation treatment it was 61.57 ± 50.32 months. A metastatic process was diagnosed predominantly in large (63.6 %) and medium (28.8 %) CM. The risk criteria for metastatic development in CM were found to be: male gender, pre-equatorial localization, fungoid shape, large tumor size, pigmented tumor, transudative retinal detachment, mixed histopathological tumor variant.

Conclusion. The established clinical and instrumental criteria of the risk of metastatic lesion in choroidal melanoma should be considered when planning follow-up monitoring of this group of patients. 

Purpose. To conduct a comparative analysis of the anatomical parameters of the eyeball in children with ametropia, congenital glaucoma, aphakia and artiphakia.

Material and methods. The study involved 73 patients (146 eyes) aged 5 to 12 years with ametropia, congenital glaucoma, aphakia and artiphakia and was carried out on an ultrasonic device STRONG 6000 T in the A-scan mode with the 10 MHz sensor set for three points.

Results. A significant increase in the size of axial length of the eyeball in moderate and high myopia and in the vertical size in high myopia were revealed. In high hyperopia, sagittal dimensions were reduced while the transverse dimensions were a bit greater than the sagittal ones. In far-advanced stage of congenital glaucoma, a significant increase in eyeball dimensions was noted both in the axial direction and in the transverse — horizontal direction. No significant differences in sagittal and transverse dimensions were noted in aphakia and artiphakia.

Conclusion. For a comprehensive assessment of the clinical course of the disease, in particular as concerns the condition of the fibrous capsule of the eye in children with ametropia, congenital glaucoma, aphakia and artiphakia, echobiometric indicators characterizing sagittal and transverse (vertical and horizontal) sizes of the eyeball should be taken into account. 

Degenerative changes in the retina of primary open-angle glaucoma (POAG) patients are developing as response to ischemia and chronic hypoxia accompanied by intolerant IOP. For this reason, the analysis of ocular blood flow changes in glaucoma monitoring, as well as the basic tests, should be considered an integral part of comprehensive examination of such patients.

The purpose is to identify the most informative markers of the disease and to assess the effectiveness of its antihypertensive therapy by the fixed combination Dorzolamide / Timolol (Dorzopt Plus).

Material and methods. 34 patients aged 68.44 ± 4.26 years with an advanced POAG stage and sub- or decompensated IOP were examined. The examination included optical coherence tomography in the angiography mode.

Results. A stable average reduction in IOP by 35.1 % (by 8.6 ± 0.7 mm Hg, p < 0.05) as compared with the baseline was achieved. IOP normalization was accompanied by a stable increase in corneal hysteresis and perfusion pressure, a decrease in the average depth of the perimetric defect, and changes in chorioretinal blood flow.

Conclusion. Changes in the choroid thickness and capillary density of the retinal peripapillary layer may be considered as the most informative biomarkers in the diagnosis of glaucoma and the evaluation of antihypertensive therapy effectiveness. 

Purpose. To study the effects of corneal collagen cross-linking (CCL) using ultraviolet-A (UVA) irradiation with riboflavin on the eye’s anterior segment structures in corneal ulcers and other keratopathies in animals.

Material and methods. The study involved 26 animals (39 eyes) — 10 cats, 10 dogs, and 6 horses with ulcers, corneal staphyloma, dry and autoimmune keratoconjunctivitis. Examination included slit-lamp biomicroscopy, ophthalmoscopy (in cases of transparent cornea), tear production test, and staining the eye surface with vital dyes. CCL was performed using UVA radiation of LEDs with a fiber optic output (wavelength 370 nm, radiation power 3 mW/cm2) combined with 0.1 % riboflavin instillation according to the protocol we developed, which specifies various numbers and durations depending on the diagnosis and therapeutic effect desired.

Results. Restoration of the shape and transparency of the cornea, relief of anterior eye inflammation, and normalization of tear production occurred much sooner than using traditional treatment. The restoration of vision occurred 2 to 3 months earlier in eyes with corneal staphyloma; more than 4 to 5 months earlier in eyes with keratoconjunctivitis; no relapses were noted in eyes with ulcerative processes, and the restoration of the function of stratified squamous epithelium was achieved within 2 or 3 weeks.

Conclusions. The inclusion of modified UFA-based CCL in the treatment scheme of corneal ulcers and staphylomas as well as dry and autoimmune keratoconjunctivitis enables a high therapeutic effect of anterior eye structure restoration. In future, the results obtained could serve as basis for using the developed technology in the treatment of similar eye pathologies in humans. 

On April 4–5, 2019, the Russian Helmholtz National Medical Research Center of Eye Diseases held a scientific and practical conference with international participation «Retinopathy of prematurity and retinoblastoma 2019». The conference, which became a platform for discussion of the most acute and burning issues of pediatric ophthalmology, was a great success. The proceedings reflect the state-of-the-art in the treatment of infants and children with retinopathy of prematurity and retinoblastoma, new technical and methodological solutions, controversial issues, and future prospects.

The complete form of X-linked congenital stationary night blindness (CSNB) is a rare genetic disease caused by a mutation in the NYX gene. CSNB is associated with the mutations taking place in 17 genes, whilst its CSNB1A form is caused by the mutations in the NYX gene, which were characterized earlier, although nothing had been reported so far about the Russian founder principle. The paper analyzes the pathogenetic mechanisms in a family with diagnosed CSNB1A and a new genetically confirmed mutation in the NYX gene in four members of one Russian family. Two brothers of the four siblings (two boys, two girls) with congenital stationary night blindness, diagnosed in early childhood, and high myopia underwent a standard ophthalmic examination, supplemented with OCT, electroretinography and color blind test with tables by Rabkin and Farnsworth test, whereupon they were sent to molecular genetics confirmation of the diagnosis by whole exome sequencing with subsequent Sanger sequencing confirmation of the detected mutation in the proband and proband’s relatives. In members of the family with clinical features of CSNB1A the reading frame shift mutation was genetically confirmed in the NYX gene (c.283delC, p.His95fs, NM_022567.2). This mutation is inherited in X-linked form. This is the first report of a case with a novel and probable founder mutation from Russia associated with CSNB1A. Since the mRNA of a NYX gene consists of only 2696 base pairs, a gene replacement therapy, or CRISPR-based gene editing, or a similar approach may be envisaged for the correction of frameshift in His95fs position.

Glaucoma is a socially sensitive disease, being one of the leading causes of irreversible visual impairment and blindness. Refractory glaucoma is one of the most severe forms of the disease as it is resistant to conservative and surgical methods of treatment. Because of pronounced postoperative fibroblastic activity of eye tissues, leading to gross scarring and obliteration of outflow paths, modern materials and methods of drainage surgery are needed. The review presents a variety of drains used today and considers in detail their main characteristics and the biocompatibility of the material used with eye tissues. Various groups of implants are presented, whose effectiveness and safety are compared and assessed. The statistics of postoperative complications and long-term results of surgical treatment are given.

The review addresses the management of primary glaucoma as a socially significant multifactorial disease. The main reasons that impede the timely diagnosis and treatment of patients with glaucoma are indicated: blurring of boundaries, conventionality of standards, and lack of individualized approach to treatment. The main risk factors for the development of glaucoma are highlighted, with special attention to hereditary predisposition and the role of “medicine of the future” in managing glaucoma. Four fundamental principles are described: personalization, prediction, prevention and participative attitude (P4 medicine). Advanced scientific understanding of the key risk factors for the development and progression of glaucoma, together with a modern personalized and personified approach will further develop precise individual strategies for the prevention and treatment of the disease.

Age-related macular degeneration (AMD) is a chronic progressive disease regarded as a leading cause of vision impairment in elderly people in industrial countries. Neovascular AMD is characterized by an increased risk of severe vision loss. Intravitreal injections of anti-VEGF medication has become a standard of treatment of neovascular AMD. Clinical trials demonstrate that the use of anti-VEGF helps stabilize the vision in at least 90 % of patients, while 30 to 40 % gain three or more lines of vision (15 ETDRS letters). However, observational studies suggest that there are barriers diminishing the efficacy of anti-VEGF treatment in routine clinical practice. Finding an optimal dosing regimen for anti-VEGF therapy that could maintain treatment efficacy with a lower number of injections and fewer monitoring visits could be a solution. The review discusses the evidence base regarding anti-VEGF dosing principles and analyzes current dosing regimens with regard to their benefits and limitations.