Purpose. To develop a new optotype and a chart for precision visometric tests and assess their accuracy.

Materials and methods. 56 patients aged 16 to 57 years with the maximum visual acuity (VA) of 1.0 or more were examined for VA using three types of optotypes: standard letter optotype based on the Sivtsev — Golovin table, Landolt rings, and a new optotype developed by the authors.

Results. On the basis of the psychometric analysis, the corresponding curves were drawn. When using the new optotype, the share of correct answers for VA = 1.0 was 75 %, for VA = 1.5 — 25 %, and for VA = 2.0 — 10 %. In contrast, Landolt rings and Sivtsev — Golovin optotypes gave the following results, respectively: VA = 1.0 — 50 %, 1.5 — 20 %, 2.0 — 10 % and VA = 1.0 — 45 %, VA = 1.5 — 15 %, VA = 2.0 — 5 %.

Conclusion. The proposed optotype and the table for visometric tests, based on the principle of logarithmic progression of optotype sizes, significantly increase the accuracy of VA assessment. An extended range of optotype sizes increases the sensitivity of the visometry.

To evaluate the efficiency of modern imaging methods of meibomian gland ducts and determine the tear film break-up time (TFBUT) during therapy in patients with the secondary dry eye syndrome (SDES) of allergic etiology.

Material and methods. 66 patients aged 38.0 ± 1.5 with SDES after allergic conjunctivitis were examined. The patients were divided into 2 groups depending on the therapy administered. The main group (n = 33) received Oftalron as tear replacement therapy for 20 days, 2 drops, 2 times a day. The patients of the comparison group (n = 33) used Super Optic HydroBalance for 20 days, 2 drops 2 times a day. The control group consisted of 25 healthy subjects without eye pathology. All subjects underwent Schirmer’s tests I and II, as well as TFBUT and meibography on an automatic refractokeratometer HRK-9000A (Huvitz, Korea).

Results. In both SDES groups, a significant decrease of the OSDI (Ocular Surface Disease Index) in the treatment process was observed (p ≤ 0.05), which corresponded to low intensity of SDES symptoms. In both groups morphofunctional changes of meibomian glands of 1 and 2 stages prevailed. The most significant dynamics was observed in TFBUT results, they were significantly lower in comparison with the similar indexes in the patients of the control group.

Conclusion. Specific modes of autorefractokeratometer HRK-9000A allow receiving objective information about the condition of the tear film and high-quality imaging of meibomian glands, which allow expanding possibilities of complex diagnostics of various forms of DES.

Purpose. To study the effect of bright sunlight on immature retina of a premature baby at different periods of solar activity.

Material and methods. The study involved two groups of premature babies: 32 babies (64 eyes) in 2016 and 50 babies (100 eyes) in 2017. Both groups were tested using a retinal camera (RetCam Shuttle, USA) on the 3rd or 4th week after birth. In cases of threshold stages of retinopathy of prematurity (ROP) binocular ophthalmoscopy were performed. In such cases, laser coagulation of the retina was performed using "ALOD 01" (ALCOM Medica, Russia).

Results. The greatest number of ROP with the greatest number of surgical interventions and adverse outcomes that required vitreoretinal surgery were revealed in the second seasonal period (May — August), which experienced the highest solar activity. In 2016, the amount of ROP cases diagnosed in this period amounted to 59 %, which is comparable with the corresponding amount revealed in 2017 (61.1 %).

Conclusions. Stronger solar activity and its longer periods increase the risk of ROP; consequently, to prevent this pathology, the eyes of the newborn should be protected from the negative effects of daylight and artificial light, including that emitted by diagnostic equipment.

Purpose: to evaluate the efficiency of simultaneous topography-guided photorefractive keratectomy (PRK) with accelerated collagen cross-linking in the treatment of stage I keratoconus.

Material and methods. 38 patients (49 eyes) aged 18 to 44 with stage I keratoconus were treated with simultaneous topography-guided PRK combined with accelerated corneal collagen crosslinking. Along with standard ophthalmological testing, patients underwent aberrometry, confocal microscopy, optical coherence tomography of the cornea, imaging of the anterior eye section on a Scheimpflug analyzer, and examination of the biomechanical properties of the cornea. The follow-up period was 2 years.

Results. Two years after surgery, uncorrected visual acuity which originally was 0.23 ± 0.03 showed a statistically significant increase and reached 0.72 ± 0.02; best corrected visual acuity improved from 0.44 ± 0.03 to 0.89 ± 0.02; the refractive power of the cornea fell from 45.03 ± 0.28 to 42.55 ± 0.31 D; the spherical component of refraction reduced from -2.00 ± 0.19 to -0.73 ± 0.09 D; the cylinder component reduced from 2.46 ± 0.14 to 0.79 ± 0.07 mm, the thinnest point of the cornea reduced from 486.30 ± 4.78 to 406.80 ± 6.51 μm. The highest order aberrations showed the following results: Coma index reduced from 0.27 ± 0.12 to 0.08 ± 0.07, Tilt reduced from 0.53 ± 0.11 to 0.10 ± 0,09, and Trefoil reduced from 0.13 ± 0.04 to 0.05 ± 0.02.

Conclusion. The analysis of clinical and functional results, biomechanical properties and structures of the cornea confirmed the efficacy and safety of the combined treatment of patients with stage I keratoconus.

Purpose. To analyze the daily dynamics and the parameters of intraocular pressure circadian rhythm (IOP CR) in patients with primary open-angle glaucoma (POAG) (stable and progressive forms) and determine chronobiological regularities of glaucoma progression depending on the patterns of restructuring the daily dynamics of IOP CR and body temperature.

Material and methods. The study included 75 POAG patients, of which 35 had a stable form (S-POAG) and 40 had a rapidly progressing form (P-POAG). The control group was composed of 80 subjects without POAG. The index of retinal ganglion cell loss measured by optical coherence tomography (OCT) was used as a criterion of POAG progression. IOP was measured by the patients themselves for 72 hours at 7 time points (3 am, 8 am, 11 am, 2 pm, 5 pm, 8 pm, and 11 pm, who used an Icare ONE portable intraocular pressure tonometer for individual use.

Results. IOP daily dynamics was distributed differently in the different groups. In S-POAG, the peak values were mainly reached in the morning hours, while the minimum values were observed at night. In P-POAG, the peak values of IOP were contrariwise recorded at night. In both POAG groups, an increase of irregular fluctuation share was noted, which indicated a decrease of the CR contribution to the IOP CR. Moreover, in POAG, a change in the phase ratio between the IOP CR and CR of body temperature was observed. For IOP CR phase violation manifestations, the threshold value of GCS global loss index was determined at 10–15 % according to OCT data.

Conclusion. IOP daily dynamics were shown to differ in S-POAG and P-POAG patients. In both groups. Signs of desynchronization were detected. The ganglion retinal cell global loss index can be used to determine phase disturbances of IOP CR.

Purpose: to study the efficiency of Bowman layer transplantation (BLT) in corneal stroma for the treatment of progressive keratoconus (KC).

Material and methods. 30 patients (30 eyes) with progressive KC stages III to IV (according to Amsler — Krumeich classification), underwent BLT into a mid-stromal pocket. At the time of surgery, the patients were 14 to 37 (averagely 26.6 ± 6.2 years). Before and after the surgery, the maximum keratometry index (Kmax) and the corneal thinnest point (CTP) values were determined. Also, we evaluated visual acuity before and after surgery in scleral contact lenses, endothelial cells density (ECD) and the depth of graft location. The indication for surgery was the refusal of corneal transplantation, progression of KC, contraindications for ultraviolet crosslinking or implantation of intracorneal ring segments based on the CTP and Kmax values. The follow-up continued 6 to 36 months (averagely, 26.6 ± 6.0 months).

Results. Throughout the observation period, no intra or postoperative complications associated with BLT or deterioration of CTP, Kmax or best corrected visual acuity (BCVA) in scleral lenses were noted.

Conclusions. Kmax, CTP and ECD values remaining stable during the follow-up is the evidence of a stabilizing BLT effect on the KC progression. The absence of BCVA decrease in scleral lenses indicates a functional safety of BLT.

Purpose. To study the state of refraction, accommodation, and blood flow in eye vessels of children with habitually excessive accommodation stress (HEAS) and pseudomyopia practicing badminton.

Material and methods. The study involved 11 patients (20 eyes) aged 7 to 11 years (average M±SD: 9.24 ± 1.06 years) with pseudomyopia and HEAS: 4 patients with myopia (7 eyes), 3 children with hyperopia (6 eyes), 4 children with emmetropia (7 eyes) before they started practicing badminton and after playing it for a certain time. All patients were tested for visual acuity, subjective and objective accommodation, optical biometry, aberrometry, velocity of blood flow in eye vessels, and choroidal thickness.

Results. After 1 year of regular badminton workout, the subjects revealed a 0.92 ± 0.82 D weakening of manifest refraction, a decrease in accommodation tone by 0.85 ± 0.77 D, an increase in blood flow rate in ophthalmic artery and the central retinal artery, an increase in positive spherical aberration, a decrease in aberrations associated with mismatch and irregularity ofoptical system elements (tilt, trefoil, coma), which indirectly indicates a strengthening of the ligamentous apparatus of the lens.

Conclusion. Practicing sports (badminton) contributes to the elimination of pseudomyopia, improvement of uncorrected visual acuity, accommodative ability, and ophthalmic hemodynamics indicators.

Purpose. To study the involvement of dopamine and noradrenaline in the pathogenesis of retinopathy of prematurity (ROP) on an original rat model of the disease.

Material and methods. The study was conducted on 41 newborn Wistar rats (82 eyes), divided into 2 groups: experimental (EROP, rats with experimental ROP, n = 21) and control (n = 20). The rats were taken out of the experiment on the 7th, 14th, 23rd and 28th days of life. All rat pups were given binocular enucleation at the indicated times, whereupon the eyeballs were dissected along the limbus and the cornea, lens, hyaloid system, and vitreous were removed. The retina was isolated from the eye cup. The isolated retinal samples were homogenized in 10 volumes of 0.1 n HClO4 containing 50 pmol/ml (or more) of 3,4-dihydroxybenzylamine (DBA), using an ultrasonic homogenizer (Labsonic M, Sartorius), centrifuged at 2000g for 20 minutes, and the norepinephrine, dopamine and precursor of dopamine — L-3,4 dihydroxyphenylalanine (L-DOPA) were determined in the resulting supernatant. The contents of substances were measured using reverse phase high performance liquid chromatography with electrochemical detection (Amperometric detector LC-4B, Bioanalytical Systems, USA) set at the potential of 850 mV.

Results. On the 7th day, on which avascular retinal zones in both groups of animals existed, no significant differences were found in the content of monoamines in the retina of rats with EROP and in the control group. On the 28th day, the content of noradrenaline, dopamine and L-DOPA in the retina of the experimental group was significantly increased compared with the control. On day 23, corresponding to the peak of neovascularization in the EROP model applied, the level of norepinephrine in the retina of experimental group rats was significantly higher, while the level of L-DOPA was significantly lower compared to the control group. The dopamine level was comparable in both study groups and similar to the level of L-DOPA in the control group. On the 28th day, corresponding to the beginning of EROP regression accompanied by vascular activity decrease, the content of dopamine and L-DOPA remained lower than in the control group.

Conclusion. During the development of pathological neovascularization of rat pup retina with EROP, the level of noradrenaline is growing, revealing a peak corresponding to the period of pronounced pathological growth of retinal vessels within the applied model, which indicates to the fact of noradrenalin proangiogenic properties and its direct participation in the pathogenesis of ROP. The level of dopamine and its predecessor, L-DOPA, increased towards the 14th day as compared to its level detected on the 7th day, which may be due to the maturation of the amacrine cells producing, and then, on the day 23. i. e. during the period corresponding to the maximum peak of angiogenesis, its relative decrease of L-DOPA was noted. It can be assumed that the lack of this monoamine, and hence insufficient manifestation of its anti-angiogenic properties contributes to the development of uncontrolled neovascularization of the retina.

Purpose: to analyze the technique of outpatient operations using radiowave surgery.

Material and methods. The clinical group of 691 patients (691 eyes; 315 men and 376 women aged 39.7 ± 4.2 years), with various pathologies of the eye and adnexa, in particular papilloma, eyelid cyst, abscess, chalazion, contagious mollusk, pterygium, pinguecula, conjunctival cyst, trichiasis, xanthelasma were observed for 2 years. Surgical treatment of adnexa neoplasms was performed using a Surgitron radiowave apparatus (USA) in three modes.

Results. Multiple techniques of radiowave surgery targeting specific eye and adnexa pathologies are presented. Using electrodes of varied configurations enables the application of radio knives practically in all ophthalmoplastic surgeries belonging to “minor surgery”. The presence of flexible microwires on electrodes with changeable shapes contributes to improved surgery results.

Conclusion. Radiowave technique of cutting and coagulation with the help of a radio knife not only reduces the time required for surgery but increases the convenience for the surgeon performing individual stages of the operation, or the whole operation. The disinfecting properties of the tips emerging due to the action of radiowaves help prevent the relapses of diseases and reduce the time of wound rehabilitation, thereby improving the cosmetic effect of the intervention.

Clinical data on new directions in combined treatment of neurotrophic keratitis, including anti-inflammatory therapy are presented.

Purpose. To compare the effectiveness of bromfenac 0.09 %, nepafenac 0.1 % and indomethacin 0.1 % eye drops in the treatment of neurotrophic keratitis (NK).

Materials and methods. 22 NK patients, aged 34 to 78, were divided into three groups. Group I received bromfenac 0.09 %, group II, nepafenac 0.1 %, and group III, indomethacin 0.1 %. Ophthalmic tests included visometry, biomicroscopy, corneal sensitivity determination, as well as diagnostic tests to determine indicators of tear production (Schirmer test, Norn test, LIPCOF test), and measuring lacrimal meniscus height.

Results. Between visits V2 and V3, patients of group III showed an increase in conjunctival irritation to an average of 2.3 points, while groups I and II revealed the condition of the conjunctiva at 0.9 and 1.1 points, respectively. The lesion area was evaluated in points (max = 20) and averaged on V1 6.8 points in group I, 5.9 points in group II and 7.2 points in group III. Keratopathy in group I which was estimated at 3.8 points before V2, dropped to 1.4 points by V3. In group III it was 1.7 points by V3. In group II, keratopathy showed only 4.1 points by V3. The average Norn test on the day of treatment showed 2.7 seconds in group I, 2.5 seconds in group II, and 3.1 seconds in group III. No significant increase in Schirmer's test results in all groups was recorded.

Conclusion. The use of non-steroidal anti-inflammatory eye drops of various groups — bromfenac 0.09%, nepafenac 0.1 % and indomethacin 0.1 % — gave a positive result in NK therapy. However, bromfenac 0.09% instillations administered once a day produce a higher anti-inflammatory effect then the same quantity of nepafenac 0.1% and indomethacin 0.1 % instillations.

The first part of the review [ROJ 2019; 12 (2): 83–95] presented a detailed description and clinical interpretation of traditional methods of drug delivery in ophthalmology, and offered an analysis of their advantages and disadvantages. This paper is a second part of the review, which focuses on rarely used and largely forgotten methods, as well as targeted means of drug delivery to the different structures of the eye.

Experimental animal studies proved that by manipulating with the defocus one can slow down or speed up the eye growth. The leading mechanism among modern optical strategies of myopia progression treatment is to induce myopic defocus to retinal periphery or decrease the hyperopic defocus. This review sums up the data on peripheral refraction in orthokeratological, multifocal contact, and multifocal spectacle correction. The effectiveness of these methods in myopia control in children and teenagers is shown.

Choroidal melanoma is a malignant tumor prone to early metastasis. Its clinical picture is polymorphic, as a result of which it can simulate many diseases of the fundus, which are referred to in the literature as pseudomelanomas. Among these are: choroidal nevus, localized choroidal hemangioma, melanocytomas, choroidal metastatic carcinoma, congenital hypertrophy of retinal pigment epithelium, late stage of age-related macular degeneration, focal retinal choroiditis, organized subretinal hemorrhage, retinal hemangiomas. However, studies comparing the clinical signs of all listed pseudomelanomas and small choroidal melanoma are few. The first part of the review describes the ophthalmoscopic picture of the small choroidal melanoma and pseudomelanomas.