The novel coronavirus infection (COVID-19) caused by SARS-CоV-2 virus, may lead to ocular diseases besides affecting the respiratory system. Cororonavirus infection may be transmitted not only through the respiratory system but also through the conjunctiva. The review article summarizes the data on the origin and variants of coronaviruses that infect humans, as well as on SARS-CоV-2 structures. Literature data on prospects of molecular diagnostics of the disease, coronavirus type detection methods, clinical sample types and duration of the disease before it is diagnosed are discussed. The data on the relationship between the coronavirus infection and conjunctivitis are given. Molecular tests of the tear and conjunctival swabs were used to diagnose the coronavirus infection independently of whether symptoms of ocular disorders were present. The real-time reverse-transcription of RNA polymerase chain reaction (PCR) was the most informative method for diagnosis of SARS-CоV-2 in the early stage of COVID-19 (until the 9th day). The presence of SARS-CоV-2 in the tear fluid and conjunctival swabs indicates the need for safety measures to prevent virus transmission through the ocular surface, including protective goggles to be worn by healthcare workers. Since side effects in the eye may appear, COVID-19 patients with visual impairment who received etiotropic or pathogenetic treatment are advised to consult an ophthalmologist.

Purpose: to assess the clinical significance of detecting organ-specific sensitization in chronic posttraumatic uveitis (CPTU) based on a comparative analysis of data from the leukocyte migration inhibition test (LMIT) and histological examination.

Materials and methods. We examined 54 patients aged 17-82 with CPTU who underwent surgical removal of the eyeball (by enucleation/evisceration). To detect organ-specific sensitization, the LMIT in whole blood with extracts of corneal, lens, and uvearetinal tissue antigens was used. The eyes were subjected to histological examination after removal.

Results. A positive response in LMIT was detected in 35.2 % of patients with CPTU. Pathomorphological signs of immune inflammation were found in 55.5 % of cases (30 eyes). In 23 eyes (42.6 %), the morphological picture was characterized by atrophic, fibrous and dystrophic changes in tissues. Based on the data from a comparative analysis of LMIT results and histological studies, we showed that in 16 cases out of 30 (53.3 %), morphologically confirmed immune inflammation was accompanied by sensitization to antigens of eye shells.

Conclusions. In half of the cases, a productive inflammation, detected in CPTU during histological examination, was associated with the development of specific sensitization to eye tissue antigens. This result is important and should be considered when choosing how the patient should be managed, including targeted diagnostics and immunotropic therapy. The negative organ-specific response of LMIT in patients with chronic CPTU and intraocular inflammation confirmed by pathomorphological signs suggests a possible involvement of additional mechanisms of the inflammatory process, which requires further research.

Purpose: to identify statistically significant factors that determine adherence to long-term follow-up on the part of patients receiving anti-VEGF therapy for macular diseases.

Material and methods. A retrospective analysis was performed on 247 patients (153 women, 94 men) aged 24 to 92 years treated with anti-VEGF for “wet” age-related macular degeneration (n = 164), diabetic macular edema (n = 18), macular edema due to retinal vein occlusion (n = 35) and myopic choroidal neovascularization (n = 30). Demographic data and treatment results were statistically analyzed with the STATISTICA 13.3 program (normal conditions for variables, non-parametric and parametric criteria were determined).

Results. Follow-up duration was shown to depend on gender (women are more committed to long-term treatment, p < 0.05), diagnosis (the longest follow-up related to myopic choroidal neovascularization patients), initial and final visual acuity. The comparison of subgroups of patients with the longest (over 30 months, n = 56) and shortest (till 12 months, n = 92) follow-up showed that prolonged monitoring corresponds to higher values of the initial (p < 0.01) and final (p < 0.05) visual acuity, as well as a lower average number of injections over the entire follow-up (p < 0.001) and a younger age of patients (p = 0.02).

Conclusion. The follow-up duration depends on gender and age, the intensity of treatment, as well as on the initial and final visual acuity at a significance level of ˂ 0.05. Also, the follow-up duration depends on the particular diagnosis. An indicator clearly reflecting the severity of the burden of treatment is proposed: the coefficient of therapy intensity which is inversely related to the patient’s adherence to therapy.

The purpose is to evaluate the effectiveness and safety of Ahmed valve implantation in children with refractory postuveitic glaucoma (PUG).

Material and methods. Ahmed valve was implanted to 10 children aged 7 to 17 years (10 eyes) with open-angle or mixed PUG uncompensated even by a maximum antihypertensive mode. Previously, all patients had undergone an average of 2.1 ± 0.9 surgeries aimed at normalizing the intraocular pressure (IOP) (predominantly, sinus trabeculectomy). 6 eyes were pseudophakic, 2 phakic, 2 aphakic. Ahmed valves were implanted according to the generally accepted technique. At the time of surgery IOP was 30.50 ± 4.35 mm Hg on average. The follow-up postsurgical period ranged from 3.9 to 23.6 months (averagely, 14.1 ± 6.5).

Results. A stable hypotensive effect of the intervention was achieved in 90 % of cases, of which 3 patients had no hypotensives while 6 patients received hypotensive drugs even though their quantity was significantly smaller than before surgery (1.7 ± 1.49, p=0.028). At the end of the follow-up the average IOP was 18.1 ± 5.34 mm Hg, (significantly lower than before surgery, p = 0.008). During surgery, 1 patient experienced bleeding from the vessels of the anterior chamber angle after paracentesis, which was stopped by tamponade with sterile air. In other cases, the surgery as well as the immediate and distant postoperative period showed no complications.

Conclusion. Ahmed valve implantation is an effective and safe method of the surgical treatment of refractory PUG in children and can be recommended in cases when previous antiglaucomatous operations proved ineffective, including patients with pseudophakia and aphakia.

Purpose: to evaluate the changes in electrophysiological indicators reflecting various aspects of the function of retinal ganglion cells (RGC) and their axons in the early diagnosis of glaucomatous optic neuropathy (GON).

Material and methods. Two clinical groups, (1) 35 patients (60 eyes) aged 49 to 70 with suspected glaucoma and (2) 16 patients (30 eyes) aged 43–68 with initial primary open-angle glaucoma (POAG), and a comparison group of 38 relatively healthy subjects (45 eyes) aged 42–70 were tested for pattern-reversed visual evoked potentials (PVEP), transient and stationary pattern-ERGs (PERG) according to ISCEV, and photopic negative response (PhNR).

Results. The P100 amplitudes in both clinical groups differed significantly from the norm in PVEP on small and large patterns. The elongation of peak latency (T) of P100 compared with norm was significant for the stimulus 1° in group 2. In both groups of patients, increased variability of the temporal parameters of PERG and PVEP for small patterns was found. In groups 1 and 2, a decrease in the amplitude of P50 and N95 peaks of transient PERG for all stimuli was revealed, which was the most significant for the 0.3° pattern. In group 1, the N95 peak was significantly delayed in PERG for large patterns. A statistically significant reduction in the steady-state PERG's amplitude was found in the groups of suspected glaucoma and initial POAG. The sharpest changes were found for small (0.8° and 0.3°) patterns. The elongation of T compared to the norm was most pronounced for PERG at 0.3°, but due to the high variability of temporary indicators within the group, it had no statistical significance. The amplitude of PhNR was significantly different from the norm in the ERG for a flash of 3.0 cd·sec/m².

Conclusion. In patients with suspected glaucoma, a decrease in the P100 VEP amplitude with the simultaneous elongation of T may be considered as a criteria for the plastic stage at the level of lateral geniculate nucleus. Markers of functional changes in RGCs are the decrease in the amplitude of PhNR in response to bright flash, and P50 and N95 of PERG for pattern size 0.3°. The results indicate a greater vulnerability of the parvocellular system to early events in the development of GON.

Purpose of the study is to determine the reliability of OCT angiography in the diagnosis of type 1 choroidal neovascularization (CNV) in wet age-related macular degeneration depending on the height of pigment epithelium detachment (PED).

Material and methods. The study included 82 patients (114 eyes) with confirmed type 1 CNV, who were examined using spectral OCT and OCTA. The patients were divided into two groups depending on PED height: group 1 consisted of 69 eyes with PED height less than 300 μm, while group 2 (45 eyes) had PED height of more than 300 μm. A separate comparative analysis of the visualization of pathological vessels was made in a group of untreated patients (56 eyes) and a group of patients (58 eyes) treated with angiogenesis inhibitors.

Results. In group 1 with a PED height less than 300 μm (167.0 ± 60.4 μm) OCTA detected blood flow along abnormal vessels in 100 % of cases. In group 2 with a PED height above 300 μm (484.7 ± 131.9 μm) CNV vessels were visualized in 24.4 % of eyes. The PED height of patients after intravitreal injections of angiogenesis inhibitors (IVI IA) ranged from 38 to 683 μm (221 ± 133 μm). According to OCTA visualization of type 1 CNV vasculature was noted in 55 eyes (94.8 %). In patients who received no antiangiogenic therapy, with a PED height 59 - 800 μm (238 ± 149 μm) CNV was visualized in 41 % of cases (23 eyes).

Conclusion. OCTA showed high reliability in the diagnosis of type 1 CNV with low PED. This method was significantly less informative when the height of the neovascular PED exceeded 300 μm, with the exception of PED after IVI IA.

Purpose. To evaluate the overall, disease-specific, event-free, relapse-free survival of retinoblastoma (RB) patients and cumulative probability of eye survival in such patients.

Material and methods. The study included 223 children with RB (126 male, 97 female). Monolateral disease was diagnosed in 69.1 % of cases (n = 154), bilateral disease in 30.9 % (n = 69). The median follow-up was 40 months (interquartile range from 27 to 53 months). According to ABC classification, group A was diagnosed in 16 of 292 eyes (5.5 %), group B — in 53 (18.2 %), group C — in 41 (14.0 %), group D — 58 (19.9 %), and group E — in 124 (42.5 %). Group E was detected twice as often in patients with unilateral RB as in bilateral RB (56.5 % versus 26.8 %; p < 0.01). Stage T1 according to TNM classification was diagnosed in 69 cases (23.6 %), stage T2-T3 — in 213 cases (72.9 %). The extraocular form (stage T4) was detected in 3.4 % of cases (n = 10).

Results. The overall five-year survival of patients treated for RB (n = 223) was 96.4 ± 1.4 %. The 5-year disease- specific survival (n = 222) was 96.8 ± 1.3 % in the general cohort, 96.5 ± 1.5 % in the group of children with monocular RB, 97.3 ± 2.7 % for binocular RB. Five-year event-free survival rate of children who received treatment (n = 223) was 66.7 ± 3.6 %, with monolateral lesion (n = 154) — 74.1 ± 4.2 %, with bilateral lesion — 50.6 ± 6.2 % (n = 69). Five-year relapse-free survival took place in 83.3 ± 3.1 %, with monolateral RB — 87.8 ± 3.3 %, with bilateral RB — 73.3 ± 6.4 %. Primary enucleation was performed in 121 of the 223 children treated for RB and included in the study. The frequency of primary enucleation with monocular RB was more than twice as high (55.2 %; 85 of 154 eyes) as with binocular RB (26.1 %; 36 of 138 eyes; p < 0.01). Organ-preserving treatment was carried out in 138 cases (171 eyes). It was effective in 123 (89.2 %) children (152 eyes; 88.9 %). 5-year ocular survival was 85.7 ± 3.7 %, with monolateral RB — 78.2 ± 6.6 %, with bilateral RB — 92.2 ± 2.8 %. Ocular survival counted separately for groups A, B, C, D, equaled 100 %, 100%, 76.6 ± 6.9 %, and 71.1 ± 11.9 %, respectively. The five-year disease-specific survival rate of children with monocular lesion given eye-preserving treatment was 100%, significantly higher than after primary enucleation — 93.4 ± 2.9 %.

Conclusions. Modern combined retinoblastoma treatment is able to save the sick children’s lifes and and even their eyes and visual functions, which improves social adaptation and quality of life. It has been shown that, with a binocular form, it is possible to save more eyes than with a monocular form. Eye-preserving treatment administered to patients with intraocular RB under strictly observed criteria does not heighten the risk of metastasis. Yet timely enucleation in cases of absolute indications remains the method of choice in saving the life of a child.

Рurpose. A comparative analysis of clinical and morphological features of retinal detachment (RD) in pediatric and adult practice.

Materials and methods. A retrospective analysis of 100 case histories of patients with a confirmed diagnosis of RD in children aged 7 to 18 (mean age 12.6 ± 1.2 years) and adults aged 19 to 80 (mean age 56.8 ± 2.4 years) was performed prior to standard surgery (subtotal vitrectomy with endolaser coagulation and filling of the vitreous cavity with tamponade substances) and 6 months after it. The main parameters for the comparative analysis were gender, age, RD type, cause (risk factor), stage of development of proliferative vitreoretinopathy (PVR), best corrected distance visual acuity, intraocular pressure, presence of postoperative complications, anatomical adherence of the retina after surgery, the fact of reoperation. Statistical analysis was carried out according to two criteria — chi-square and Fisher's test.

Results. Statistically significant differences in the type and cause (risk factors) of RD, were found. In children, rhegmatogenous RD was less common than in adults (69 % of cases compared with 80 % of cases), while traction RD was more common in children (29 % of cases compared to 19 % of adult cases). The C stage of PVR development in children were found to be almost twice as common as in adults. Postsurgical outcomes were found to be significantly higher in adults compared with children.

Conclusion. RD type, causes and outcomes are statistically different in pediatric and adult practice. Significantly less successful functional and anatomical results of RD surgery in children reflect differences in etiology, pathogenetic features (PVR stage) of the disease, as well as an increased risk of postoperative complications.

To date, the operation of choice in young patients with high myopia, is the implantation of posterior chamber phakic intraocular lenses (PIOL), provided that there are contraindications to keratorefractive interventions, However, in the late postoperative period, cataracts may occur, which requires the development of surgical tactics for lens explantation with simultaneous phacoemulsification of cataract (FEC) implementation.

The purpose is to develop and analyze a method for removing a PIOL through a 2 mm corneal incision in subcapsular cataract cases.

Material and methods. Posterior chamber domestic models of PIOL type RSK-1(3) and RSK-3 in 22 patients (37 eyes), implanted in the S.N. FEDOROV “EYE MICROSURGERY” clinic in 1994 – 2001 had to be removed due to the development of secondary cataracts. PIOL stayed in the eye 2 to 26 years (averagely 14.30 ± 1.30 yrs). In all cases, the P IOL was removed followed by FEC with implantation of a posterior chamber IOL. The optical power of the IOL was calculated mainly in such a way that the residual myopic refraction was 2.0–3.0 D.

Results. The intraoperative condition of the anterior chamber was stable, the volume of irrigation fluid consumed was within 90–120 ml. No complications were detected in the early and late postoperative periods. The results of dynamic ophthalmological follow up of patients showed that visual acuity without correction and with correction after surgery averaged 0.2 ± 0.1 and 0.60 ± 0.15, respectively.

Conclusion. The proposed method of explantation of domestic lenses of S.N. FEDOROV NMRC MNTK “EYE MICROSURGERY” shows that it enables a safe, simple removal of PIOL in the event of secondary subcapsular cataract, which allows achieving high clinical and functional results without overspending the irrigation solution.

Purpose. To determine the specificity of functional and tonographic parameters of the eyeball in children with cataract, aphakia and pseudophakia. Material and methods. A comparative analysis of eye hydrodynamics indices was made according to a simplified procedure, using the Friedenwald nomogram, on 75 children aged 2 to 17 years with cataract (24 eyes), aphakia (21 eyes), pseudophakia (15 eyes), and IOL dislocation (15 eyes), as well as 12 healthy children.

Results. In pseudophakia, true IOP was found to fall to 10.00 ± 0.01 mm Hg due to a decrease in aqueous humor production (to 0.10±0.01 mm³ / min) and increase of its outflow (to 0.75 ± 0.02 mm³/min / mm). IOL dislocation led to an increase in true IOP (24.40±1.0 mm Hg) due to an increase in aqueous humor production (4.09±0.05 mm³/min) and a decrease in its outflow (0.010 ± 0.002 mm³/min/mm). In these eyes, clinical manifestations of secondary pseudophakic glaucoma were noted, which are explained by factors obstructing aqueous humor outflow (vitreous prolapse and partial vitreous block) and considered an indication for re-operation.

Conclusion. Statistically significant changes of hydrodynamic eye parameters in children with pseudophakia have been detected: increased true IOP in IOL dislocation, and, conversely, reduced true IOP in case of the normal IOL location. The authors believe that eye “hypotension” in case of pseudophakia requires further study.

Purpose. To study the microbiological profile of corneal ulcers depending on demographic and clinical characteristics of patients.

Materials and methods. 97 patients (114 eyes) (65 men and 32 women) diagnosed with corneal ulcer were tested. 80 patients had unilateral and 17 bilateral ulcers. The patients’ age varied from 15 to 87 years (24.7 % aged 50–59, 27.8 % aged 60–69, and 19.7 % aged 70 or older). All patients were examined for the microbiological profile of corneal scrapings to determine the microbial flora of the corneal ulcer. The significance of gender, age and clinical differences found in the structure of the microbiological profile was evaluated by the the χ² criterion.

Results. Gram-positive microorganisms were among the most frequently detected: Staphylococcus epidermidis in 25.3 % of cases, Streptococcus pneumoniae in 21.7 % of cases, Streptococcus viridians in 16.3 % of cases, and Staphylococcus aureus in 7,8 % of cases. Gram-negative microbial flora (Pseudomonas aeruginosa) was revealed in 22.3 % of cases, while fungi were identified in 6.6 % of cases.

Conclusion. The microbiological profile of corneal ulcer depends on the patient’s age, localization, size and depth of the lesion, as well as the presence of complication. Severe and complicated forms of corneal ulcer (sized ˃5 mm, depth of the lesion exceeding two thirds of corneal thickness) are often associated with the detection of more than one type of microorganism.

A penetrating corneoscleral injury case with the development of bilateral phacoanaphylactic inflammation of a sympathetic ophthalmia kind in a 59-year-old woman is described. The case reveals a difference between bilateral phacoanaphylactic inflammation and classical sympathetic ophthalmia. Unlike the latter, the clinical case showed on the “healthy” eye a sluggish inflammation of anterior uveitis type with a slowly progressing lens opacity, for which local and systemic corticosteroid therapy proved insufficiently effective. The morphological picture showed that the inflammation was located in the anterior part of the eye around the damaged lens with the formation of a macrophage-neutrophil abscess, which is typical for phacoanaphylactic inflammation, and the absence of granulomatous inflammation in the ciliary body, where plasmacellular infiltration prevailed.

Conclusions. Phacoanaphylactic inflammation and sympathetic inflammation are autoimmune in their nature having different autoantigens. In phacoanaphylactic inflammation, autoantigen is the lens protein, while in sympathetic inflammation it is the uveoretinal antigen. The only method of treating phacoanaphylactic inflammation is to remove the cataract-altered lens. Our patient underwent phacoemulsification in her single eye, after which the symptoms of uveitis with hypertension disappeared completely and her vision was restored.

This literature review offers a detailed description of the genes and proteins involved in pathophysiological processes in isolated retinitis pigmentosa (RP). To date, 84 genes and 7 candidate genes have been described for non-syndromic RP. Each of these genes encodes a protein that plays a role in vital processes in the retina and / or retinal pigment epithelium, including the cascade of phototransduction (transmission of the visual signal), the visual cycle, ciliary transport, the environment of photoreceptor cilia and the interphotoreceptor matrix. The identification and study of pathophysiological pathways affected in non-syndromic RP is important for understanding the main pathogenic ways and developing approaches to target treatment.

Recently, much literature data is available on the issue of diagnosis of preperimetric glaucoma (PPG), but no recognized algorithms of detecting primary open-angle glaucoma (POAG) at this stage have been developed, and there is no general opinion as to what parameters and techniques should be used. The review offers a generalization of the literature data on PPG diagnosing and specifies the main parameters that should be taken into account in testing POAG patients at the early preperimetric stage. As is known, the diagnosis of glaucoma is based on detectable changes in the optic nerve head and visual field, but the onset of the disease occurs long before the above changes. Currently, the approach shifts towards early OCT diagnosis of glaucoma. Cohort studies show that structural disorders are detected 5–12 years earlier than functional ones in 17–60 % patients with POAG.

The purpose of the review is to analyze the data of recent studies (performed in the last two decades) of the efficacy and safety of sclera reinforcement surgeries for progressive myopia in children and adults. Short-term and long-term observation results are presented, indicating the impact of the initial degree of myopia, the patient's age, surgical technique and the choice of plastic material on the outcome of the intervention and the further course of the myopic process. The advantages of a biologically active synthetic graft are described, which makes it possible to deposit drugs that stimulate scleral crosslinking and have a biomechanical, trophic and hemodynamic effect. Crosslinking of scleral collagen is a promising approach to the treatment of myopia.

Neurodegenerative diseases (NDD) are a group of nosological forms, caused by excessive formation of protein molecules and their aggregates and leading to the death of brain cells. Classical pathophysiological mechanisms are associated with the accumulation of extracellular amyloid b -protein (A b) in Alzheimer's disease (AD) and a -synuclein protein in Parkinson's disease (PD), which are markers of neurodegenerative process. Signs of functional disorders in NDD include decreasing visual acuity, lower contrast light sensitivity with the most significant changes at the highest spatial frequencies (18 and 12 cycles per degree), and reduced color vision. These disorders correlate with the severity of cognitive impairment and duration of the disease. Changes in the indicators of psychophysical tests are accompanied by lower central retinal thickness (CRT), which is a consequence of inner layers degeneration. NDD progression is characterized by the stability of psychophysical tests, significant thinning of the peripapillary retinal nerve fiber layer (RNFL) and CRT thickening, which correlates with cognitive disfunction. A b and a -synuclein deposits in artery walls cause lumen narrowing and occlusion of blood vessels, reduced optic nerve disk perfusion density, superficial and deep capillary plexus depletion, expansion of the avascular foveolar zone. Microcirculatory disorders lead to retinal changes, which were proven to correlate negatively with the thickness of inner retinal layers and duration of the disease. An ever-growing need in the identification of specific and sensitive biomarkers at the preclinical stage of NDDs, differentiation of their causes, precise subtype classification, and assessment of progression risk is an evidence of the relevance of studying and identifying functional and structural changes in retinal neurons and axons. Non-invasive and informative methods of multimodal imaging appear to be valuable for NDD diagnosis and monitoring.