Purpose. To study pupillary reflexes (pupillary cycle time and pupillary reaction — V) in patients with strabismic amblyopia and concomitant alternating strabismus.

   Material and methods. 58 children (116 eyes) with concomitant alternating strabismus and strabismic amblyopia and 10 healthy children (20 eyes) with emmetropia (the control group) were examined, along with general testing, for pupillary reflexes according to S. Miller and H. Thompson’s method before and after color pulse stimulation, Sidorenko’s vacuum spectacles, and Focus and Relax programs.

   Results. All children with hyperopic astigmatism and high hyperopia showed a significant (p < 0.001) decrease in pupillary cycle time after treatment, on average, from 1317,0 ± 0.6 to 900,00 ± 2.08 m/s and an increase in the pupillary reaction rate, on average, from 1.7 ± 0.17 to 2.8 ± 0.1 mm/s. Сhildren with severe amblyopia showed more pronounced pupillary reflex disorders: pupillary cycle time was 1450,0 ± 1.0 m/s and V = 1.3 ± 0.17mm/s before treatment, whilst after treatment, significant improvements were achieved:pupillary cycle time fell to 1000,0 ± 1.3 mm/s, while V grew to 2.20 ± 0.15 mm/s (p < 0.01).

   Conclusion. The revealed disorders of pupillary reflexes in children with strabismic amblyopia indicate the pathology of the muscle part of the pupil-accommodative system and require specific treatment.

   Material and methods. 58 children (116 eyes) with concomitant alternating strabismus and strabismic amblyopia and 10 healthy children (20 eyes) with emmetropia (the control group) were examined, along with general testing, for pupillary reflexes according to S. Miller and H. Thompson’s method before and after color pulse stimulation, Sidorenko’s vacuum spectacles, and Focus and Relax programs.

   Results. All children with hyperopic astigmatism and high hyperopia showed a significant (p < 0.001) decrease in pupillary cycle time after treatment, on average, from 1317,0 ± 0.6 to 900,00 ± 2.08 m/s and an increase in the pupillary reaction rate, on average, from 1.7 ± 0.17 to 2.8 ± 0.1 mm/s. Сhildren with severe aamblyopia showed more pronounced pupillary reflex disorders: pupillary cycle time was 1450,0 ± 1.0 m/s and V = 1.3 ± 0.17mm/s before treatment, whilst after treatment, significant improvements were achieved:pupillary cycle time fell to 1000,0 ± 1.3 mm/s, while V grew to 2.20 ± 0.15 mm/s (p < 0.01).

   Conclusion. The revealed disorders of pupillary reflexes in children with strabismic amblyopia indicate the pathology of the muscle part of the pupil-accommodative system and require specific treatment.

   Ophthalmic hypertension is mostly associated with medium- or large-sized melanomas. The pathogenesis of persistent IOP elevation in uveal melanoma is not fully understood at present.

   Purpose. To analyze the clinical and morphological mechanisms of the development of secondary ophthalmic hypertension in patients with uveal melanoma.

   Material and methods. The case histories of 26 patients with T3N0M0-T4N0M0 uveal melanoma were analyzed retrospectively from 2015 to 2019. The main group included 18 patients with secondary monolateral IOP elevation while the control group was composed of 8 patients with normal IOP. Tumors in both groups were comparable in size. All patients underwent eradication treatment (enucleation/exenteration). Enucleated eys were histologically examined.

   Results. Pronounced pathological changes of the iridocorneal angle, iris and ciliary body were found morphologically in all specimens with elevated IOP. The following dominating mechanisms ofophthalmic hypertension were detected: iris and anterior chamber angle neovascularization; tumor-associated chronic uveitis; obstruction of trabecular meshwork by cellular elements (pigment-rich macrophages, blood cells, inflammatory cells); fibrosis and deformation of trabecular meshwork and Schlemm's canal; closed angle glaucoma with lens-iris diaphragm shift; tumor invasion into the angle.

   Conclusions. Investigation of morphological changes in patients with UM and found resemblances with already studied non-tumor forms of glaucoma may help find previously undetectable receptors for the development of targeted anti-tumor drugs.

   Purpose: to identify the features of the pathology of the eye in elderly and senile people in the Arkhangelsk region.

   Material and methods. Annual reports of medical eye care facilities for the 2009 to 2019 who offered ophthalmological assistance to individuals aged 60 or older were analyzed. To estimate the differences infrequency of occurrence Pearson's Chi-square was used.

   Results. The incidence of eye pathologies in elderly and senile people amounts to 20.74% (17.83 % male and 22.29 % female). The most common conditions included the pathology of the lens that occurred in almost 50 % of the old people, glaucoma was diagnosed in about 20 % and retinal conditions in one out of seven people. In the age group of 60 to 74 years, the most common pathologies included glaucoma, diabetic angioretinopathy, retinal conditions and refractive errors; in the people of advanced age (75—89 years), lens pathologies and age-related macular degeneration occurred more frequently than in the younger age group while glaucoma, diabetic angioretinopathy, retinal conditions and refractive errors occurred less frequently. The oldest age group (90 years and older) showed a different pathology distribution than people of the younger age groups: they have higher occurrence of lens pathologies, age-related macular degeneration, optic disc pathology. In contrast, they have a rarer occurrence of retinal diseases, whilst diabetic angioretinopathy or refractive errors were not diagnosed at all. Gender differences of eye pathology distribution are revealed in the fact that, among people aged 60 to 89, women have a higher occurrence of age-related macular degeneration, retinal diseases and refractive errors, while men are more often diagnosed with glaucoma.

   Conclusion. The identified features of eye pathology in elderly and senile people living in the Arkhangelsk region should be taken into account when medical care for advanced age groups is developed and improved.

   One of the serious challenges facing surgeons after congenital cataract extraction with IOL implantation in infancy is unplanned refractive results revealed in the long-term period, including the cases of myopia higher than 3.0 D in approximately 50 %.

   Purpose. The study aimed to evaluate the clinical and functional condition of the eyes in children with moderate to high myopia.

   Material and methods. Our study included a total of 33 patients (61 eyes) with pseudophakia, of which 16 (26 eyes) developed moderate (12 eyes) or high (14 eyes) myopia at the age of 5 to 15 years. Parameters of the anterior and posterior eye segments were evaluated using Galilei Dual Scheimpflug Analyzer and Optical Coherence Tomography RS-3000 Advance 2, and the axial length using Optical Biometer Al-Scan.

   Results. The central corneal thickness (CCT) was found considerably above the norm (up to 580 ± 35 pm) in most cases of pseudophakic myopia (72.2 %). Anterior chamber depth in children (4.07 ± 0.39 mm) was equal to that in adults with pseudophakia. Astigmatism and axial length in children with high
myopia significantly exceeded those in children with moderate myopia (3.5 and 1.88 D; 23.57 ± 1.31 and 25.04 ± 1.90 mm, respectively), while choroidal thickness and best corrected visual acuity (BCVA) were much lower (268 and 181 pm; 0.1 and 0.3, respectively). There were no variations in spherical equivalent between different axial length in high and moderate myopia.

   Conclusion. Taken together these results suggest that with the increase of astigmatism axial length elongated and high myopia developed in children with pseudophakia. Choroidal thickness declined due this process and may be a cause of poor functional outcome. Sufficient CCT opens possibilities for refractive surgery in those patients to improve visual outcomes.

   Purpose. To assess remote results of our method of macular hole (MH) surgery without postsurgical vitreous cavity tamponade.

   Material and methods. 34 eyes of34 patients were operated for full-thickness MH 100 to 932 (558.5 ± 50.9) microns in diameter with no vitreous cavity tamponade. Before surgery, best corrected visual acuity (BCVA) was 0.02 to 0.25 (0.11±0.02). The operation included 3-port 25—27 G vitrectomy, separation of posterior hyaloid membrane, staining and removal of the internal limiting membrane (ILM) with subsequent ex­change of salt solution for air. The hole edges were passively (without touching the retina) pulled towards the center using an extrusion cannula through air supplied into the vitreous cavity under the pressure of 20—25 mm Hg. After that, 0.05 to 0.1 ml of platelet rich plasma (PRP) of the patient was applied to macular hole zone. In 2 minutes, a fibrin film was formed at the place of application which was pressed to the retina by injecting 0.5 ml of Perfluororganic Compound liquid (PFCL) into the vitreous cavity. PFCL was exposed for 3 minutes, whereupon it was passively aspirated. The operation was completed by air exchanged for salt solution. High specific weight of PFCL facilitated a tight adhe­sion of fibrin film to the retina. The follow-up period was 1 to 20 months (7.9±0.8 on average).

   Results. After the surgery, complete closure of the macular hole was achieved in 32 of 34 cases (94.1%). No intraoperative or postoperative complications were observed. Postsurgical BCVA improved to 0.3—0,7(0.50 ± 0.05). At the initial stage of the study, a recurrence ofMH took place in two cases associated with partial mechanical displacement of the fibrin film by the cannula during PFCL removal.

   Conclusions. The proposed method of macular hole surgery avoiding postoperative vitreous cavity tamponade with gas or another vitreous substitute is effective, speeds up the rehabilitation and may be used in routine clinical practice, especially in patients with the only seeing eye, those with a transparent lens, those who need to take a plane or rise at great heights soon after the surgery, as well as those at risk of increased IOP or unable to sustain a forced head position even for a short time span.

   Intravitreal injections show an avalanche-like growth the world over.

   Purposes: 1) create a mathematical model of the eyeball and fluid movement inside the eye, assuming the simplified structure of the vitreous body (without tanks); 2) estimate the time span when the drug substance remains in the cavity of the vitreous body until it is completely washed out, depending on the injection site; 3) observe and evaluate the path of drug movement in the vitreous body cavity; 4) evaluate the variation of time when the drug is located in the vitreous body cavity, depending on the presence or absence of complete detachment of the vitreous body.

   Results. If the drug is injected closer to the center of the eyeball, the time when it is located in the vitreous is increased as compared to parietal injection. With full vitreous body detachment, the location time of the drug increases as compared to its normal location, which favorably affects the prolongation of the therapeutic effect.

   Conclusion. As this is a pilot study, many parameters are approximate, so the results obtained cannot be mechanically extrapolated to the live human eye subjected to intravitreal injections, due to the complexity of the processes occurring in eyeball.

   To prevent the spread of COVID-19, to ensure the safety of ourselves and others, personal protective equipment — various types of masks — has firmly entered our daily lives.

   Purpose to conduct a clinical and sociological study of the severity of the dry eye syndrome in medical personnel and medical students against the background of the use of personal protective equipment and to assess the possibilities of its correction using tear replacement therapy.

   Materials and methods. 138 medical staff and 149 students were analyzed. A survey was conducted to identify risk factors for the development of the dry eye syndrome. The total tear production was determined using the Schirmer I test at the beginning and after 8 hours of the working day in medical personnel and students before and after a 6-hour lesson. To study the possibility of correcting the dry eye syndrome, students were offered instillations of the tear substitute Gylan 0.18 % 3 times a day. At this stage of the study, 2 questionnaires were used to assess the severity of DES symptoms: OSDI and DEQ, Schirmer I test.

   Results. Most of the study participants noted the constant wearing of masks (86.4 % of doctors and 84.8 % of nurses). At the beginning of the study, 45.1 % of doctors and 51.9 % of nursing staff, 45.6 % of students had indicators of total tear production below the reference values. At the end of working hours, doctors (90.9 %), nurses (88.6 %) and students (69.2 %) showed a decrease in the total tear production of varying severity. The use of a tear substitute made it possible to increase the indicators of total tear production: 10 days after treatment, an increase was observed in 45.7 % of cases (but the values were in the range of 10—14 mm), in 31.4 % of cases they reached 15 mm or more and exceeded the initial values (p < 0.05); reduce the symptoms of dry eye: the number of students with DEQ questionnaire syndrome dry eye at the beginning of the study (62.9 %) decreased by 3.2 times.

   Conclusions: the conducted study allows us to speak about the currently available riskfactorfor the development of the dry eye syndrome: personal respiratory protective equipment has a negative impact on the indicators of total tear production. Appointment of tear replacement therapy allowed to improve the functional indicators of tears and quality of life. It is necessary to develop and implement measures aimed at identifying and preventing the development of the dry eye syndrome not only among medical personnel, but also among the population as a whole.

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   Purpose.  To assess the effect of adequate laser coagulation (LC) of peripheral vitreochorioretinal dystrophy (PVCRD) on the clinical and functional state of the retina and the microcirculation of the macular region.  

   Material and methods.  Ganzfeld electroretinogram (ERG), multifocal ERG (mfERG), and optical coherent tomography with a function of angiography (OCTA) were performed for the retina of 22 patients (37 eyes), aged 20 to 62, who had been given an adequate volume of LC to treat dangerous types of PVCRD. The tests took place before LC and 1, 3, 6, 9, 12 months after it. To analyze the results, two groups were formed: (1) 27 eyes with LC volume of less than 200 coagulates and (2) 10 eyes with LC volume of more than 200 coagulates.

   Results.  After LC, we observed a moderate decrease in the amplitudes of scotopic ERGs and the a-wavepeak latency lengthening in the maximal ERG. In the 2 ndsubgroup, the amplitude of the second wave of oscillatory potentials (OP2) and the OP index decreased more significantly than in the 1st, subgroup (by 17 and 21 % from the initial values, respectively, p<0.05). The cone and flicker ERGs in the 1st subgroup did not change, while in the 2nd subgroup the amplitude showed a stable decrease by 10 to 20 % as compared to the data before LC. As shown by mfERG, in the 2nd subgroup the functional activity of the macular region was moderately and reversibly declining. OCTA showed a general decrease in blood flow density (by 6.6% against the initial data) after LC, which reached the minimum 6 months after the intervention, with subsequent recovery in another 6 months. The recovery of blood flow density was complete in the 1st subgroup and partial in the 2 nd subgroup.

   Conclusion.  LC of PVCRD in an adequate volume leads to a moderate general decrease in retinal activity with the restoration to the initial amplitudes of scotopic and photopic ERGs, and mfERG within 6 to 12 months. OCTA also showed that LC conducted in an adequate volume does not significantly impair the microcirculation in the fovea zone. A moderate depression of blood flow was more pronounced in the subgroup with the higher number of coagulates.

   Purpose:  to analyze the results of a survey aimed at assessing the patients’satisfaction with the results of excimer laser or orthokeratological correction of myopia.  

   Materials and methods.  135 patients aged 35 to 50 took part in a satisfaction survey: 105 after excimer laser and 30 after orthokeratological correction of myopia. Excimer laser surgery was performed with planned binocular hypocorrection within -0.75 — 1.5 D depending on age. To participate in the survey, the patients signed a preliminary consent. The questionnaire asked for age, gender, occupation, self-assessment of visual functions under a variety of conditions (vision at dusk, at close distance, at far distance, while driving a vehicle, etc.), self-assessment of satisfaction with the result. The questionnaire required to answer 15 questions on a multiplechoice basis.

   Results. Over 50 % of the patients have no difficulty working at close distance, at far distance, or when driving a vehicle, and do not restrict themselves in professional or everyday activities. More than 90 % of the patients would recommend excimer laser correction in binocular format with a planned hypo effect or orthokeratological correction to others. 125 out of 135 patients gave the maximum satisfaction score points.

   Conclusion:  excimer laser correction of myopia with a planned hypoeffect in binocular format and orthokeratological correction can be recommended for patients over 35.

   Purpose. To optimize the technique for femtolaser-assisted anterior capsulorhexis in patients with anterior capsular fibrosis.

   Material and methods.  All patients were divided into two groups: group I included 12 patients with central and peripheral anterior capsule fibrosis who underwent anterior circular capsulorhexis usingfemtolaser LensX (Alcon, USA) with laser energy 10 and 15 J . Group I I included 11 patients with central and peripheral anterior capsule fibrosis, who underwent manual capsulorhexis.

   Results.  In group II, surgical complications oc­curred in 3 cases (27.3 %), group I was uneventful. In group I, BCVA increased to 0.80 (0.70; 0.85) over the 6 months’follow-up, in group II, it increased to 0.70 (0.60; 0.70) In group I, IOP was 16.4 (15.0; 17.4) mm Hg, in group IIit was 16.2 (13.8; 18.7) mm Hg.

   Conclusion. Femtolaser-assisted anterior capsulorhexis in patients with anterior capsule fibrosis allowed reducing the number of operative complications by 27 % in comparison with manual capsulorhexis creation. Since even the maximum power values of the femtolaser system does not allow cutting the fibrotic capsule, we can make use of smaller power values, in particular 10 pJ, to create the anterior capsulorhexis in the area of unaffected or slightly fibrotic anterior capsule and cut the fibrotic part of the anterior capsule by collet scissors.

   Despite the improvement of algorithms of preterm infants’ management, methods for predicting, diagnosing and treating ROP remains a vital issue.

   Purpose:  to improve the diagnostics of retinopathy of prematurity based on the assessment of vascular system configuration, using Key to Diagnosis I software.

   Material and methods.  279 patients with ROP were divided into 6 groups: group 1 included 152 patients (304 eyes) with stage I; group 2 — 45patients (90 eyes) with stage II; group 3 — 8patients (12 eyes) with stage III; group 4 — 7 patients (8 eyes) with stage IVA; group 5 — 7 patients (14 eyes) with posterior aggressive ROP; control group 6 — 60patients (120 eyes) diagnosed with immature retina who have no ROP signs. 28 eyes were analyzed using wide-field imaging, while 400 eyes were analyzed by separate images. The presence o f“mute” zones, macula localization, traction index of the macular zone (Tm), zone and span of pathological changes, fractal dimension (Df) and complexity of vascular system (СVS) were assessed on automatically created wide-field images, obtained by Ret-Cam Shuttle.

   Results.  We revealed strong correlation between Df and stages (p = 0.85, p = 0.01); moderate negative correlation of Тm and stages (p = 0.62, p = 0.01), except for posterior aggressive ROP; strong positive correlation between CVS and stages ( p  = 0.91, p = 0.001). Diagnostic modules of the software have been developed to create wide-field fundus imaging in infants, localize the macula as a marker for morphometry, and isolate the vascular system using deep convolutional neural networks.  

   Conclusions.  The developed algorithm for multivari­ate analysis of the retinal vascular system reduces the risks of subjective assessment of retinal changes.

   To evaluate macular thickness in patients with pseudoexfoliation syndrome (PXS) after phacoemulsification.

   Materials and methods. 30 patients with PXS (mean age 74.05 ± 5.21 years) and 31 age-matched patients (mean age 71.35 ± 7.51 years) without PXS (control group) were examined to assess macular thickness, which was measured by optical coherence tomography before phacoemulsification, 2 weeks, 2 and 6 months after it.

   Results. A significant increase in retinal thickness was noted in patients of both groups in parafovea 2 weeks after phacoemulsification, in parafovea and periphovea after 2 months, and in parafovea after 6 months. At 2 months after surgery, in patients with PXS, the thickness o f the retina in the fovea and perifovea was significantly higher than in the control group; at other times, no difference was observed between the groups.

   Conclusion. PXS does not affect macular thickness after phacoemulsification if no intraoperational or postoperational complications took place. 

   Purpose. Evaluation of long-term results of uveal melanoma (UM) treatment in patients depending on clinical, hemodynamic and morphological parameters of the tumor.

   Material and methods. Long-term results of treatment were analyzed in 394 UM patients aged 17 to 82 (mean age 53.1 ± 13.2). The median follow-up was 56 months. Group A (n = 242, organ-preserving treatment) consisted of patients with a tumor height of 5.0 ± 1.8 mm and base diameter of 12.7 ± 2.9 mm. Group B (n = 152, enucleation) included patients with 8.3 ± 2.8 mm tumor height and 15.2 ± 4.1 mm base diameter. Overall survival and disease-dependent survival were determined.

   Results. The cumulative 3-, 5-, and 7-year survival rates of patients with choroidal melanoma were 91.6 ± 1.7, 84.0 ± 2.5, 74.0 ± 3.8 % , and those with ciliochoroidal melanoma were 84.2 ± 5.6, 79.9 ± 5.8, and 53.0 ± 14.7 %, respectively (p = 0.048). In group A, the 5-year survival rates of patients with mushroom-shaped and irregular forms were 80.6 ± 5.9 and 74.6 ± 10.9 %, respectively, and 96.0 ± 2.0 % for dome-shaped UM. The worst 5-year survival rates were shown by patients with tumor stabilization, and the best ones, by patients with complete tumor resorption (x2 = 6.880, p = 0.008). Patients with post-radiation optical neuropathy (n = 193) had better 5-year survival rates (90.3 ± 2.9 %) than patients (n = 49) without neuropathy (77.5 ± 8.0 %). In group B, cumulative 1-year survival was 95.2 ± 1.9 %, 2-year survival, 89.2 ± 2.8 % , 3-year survival, 84.9 ± 2.9 % , 4-year survival, 81.8 ± 3.6 %, 5-year survival, 77.5 ± 4.0 % , 6-year survival, 67.9 ± 4.8 % , and 7-year survival was 64.7 ± 5.2 %. In epithelioid-cell, mixed-cell, and spindle-cell types of UM, the 5-year survival rates were 46.3 ± 12.0, 70.7 ± 8.0 %, and 84.8 ± 5.4 %, respectively (x2 = 11.571, p = 0.004). The 5-year survival rate of patients with extrascleral growth was 56.0 ± 10.4 % and without extrascleral growth it was 81.7 ± 4.0 %.

   Conclusion. In organ-preserving treatment, the combination of prognostic factors allows us to stratify the patients based on the risk of early metastasis, which allows for personalized dynamic monitoring, taking into account the vital prognosis of a particular patient.

   Purpose:  to study ocular manifestations in acute COVID-19 patients with severe or extremely severe course.

   Materials and methods. 112 patients with severe and extremely severe course ofCOVID-19 treated in the 2nd Zangiota specialized clinic for Covid patients underwent an ophthalmic examination.

   Results. Hyperemia of palpebral edges was found in 20 patients (17.8 %), tarsal conjunctiva hyperemia was found in 54 patients (48.2 %), whereas 11 patients (9.8 %) had symptoms of eyeball conjunctiva hyperemia. 27 patients (24.1 %), complained of pain in the projection of external muscle tendons attachments during eyeball palpitation. Retinal angiopathy of varied genesis were found in 57 patients (50.9 %). Blurred edges of the optic nerve and smoothness of physiological excavation were observed in 11 patients (9.8 %). We were able to trace the medical history of 25patents over two months after the discharge. Ofthese, 17 patients (68 %) visited an ophthalmologist and were diagnosed with dry eye syndrome, and 1 patient was diagnosed with uveitis. 4 patients complained of blurred vision, disorientation and memory loss. 1 patient was found to have episcleritis. 3 patients (12%) complained of a dramatic decrease of vision in one eye, ptosis, swollen eyelid and exophthalmos. They were diagnosed with thrombosis of the cavernous sinus and superior orbital fissure syndrome.

   Conclusion. The main ophthalmic symptoms of the anterior segment of the eye in patients in the acute stage of COVID-19 with severe and extremely severe courses were manifestations of dry eye syndrome, short-term manifestation of tenonitis of oculomotor muscles. In 50 % cases, angiopathy of the anterior and the posterior segments of the eyeball were observed. Severe manifestations of general coagulopathy and angiopathy developing superior orbitalfissure syndrome were observed in 12 patients within weeks after the patient's dischargefrom the clinic.

   The most common factors determining the unfavorable choroidal melanoma (CM) prognosis are: patient's advanced age, tumor size, epithelioid histotype, developed vascularization and extrascleral tumor extension. Also, there are indications ofan unfavorable vital prognosis when hemorrhages appear in the tumor area. There are suggestions that retinal changes detected by optical coherence tomography (OCT) are comparable to the results of morphological studies, and the structure of the choroid determined by EDI-OCT (enhanced depth imaging) matches its morphological structure.

   Purpose: to assess the possibility of in vivo detection of morphological signs of CMspreading into the retina according to OCT data.

   Materials and methods. 5 CM patients aged 55.20 ± 10.57 who subsequently underwent primary enucleation, were tested by OCT that showed the maximum CM elevation of 4.85 ± 1.76 mm, and the maximum diameter of13.09 ± 4.14 mm.  Results. The correlation of tomographic and histological picture was obtained in the following signs: destruction of Bruch's membrane, presence of hyperreflective changes at the level of retinal pigment epithelium (deposits and extended areas of its thickening), photoreceptors changes, neuroepithelial detachment, the intraretinal cavities. A partial correlation took place for signs of subretinal transudate and infiltration of the outer layers of the retina. No correlation was obtained for the signs of infiltration of inner retina layers and the inner limiting membrane rupture with CM dissemination on a retinal surface. The cases of divergent interpretation between OCT and morphological studies are as­ sociated with the presence of fibrosis foci due to a formation of superficial tumor necrosis and foci of proliferation of the pigment epithelium with its dissemination into the inner retina layers.

   Conclusion. Comparison of OCT signs ofM C with pathomorphological data obtained from 5 enucleated eyes made it possible to expand the interpretation of OCT signs of CM spreading beyond the Bruch's membrane with the forma­tion of tumor growth zones in the retina.

   Purpose.  To develop a new method of amblyopia treatment in children with unstable central and eccentric fixation by centralizing visual fixation and increasing retinal photosensitivity in the macular region using biofeedback.

   Material and methods.  The study included 27 patients (27 eyes) with amblyopia of various origins, aged 5 to 17 (averagely 9.15 ± 3.19 years), who were able to perform training sessions on the MP-3 Nidek microperimeter (Japan). In addition to standard examination, all patients underwent binocular status assessment using a four-point test, macular electroretinography, microperimetry, optical coherence tomography (OCT). The treatment, carried out on the microperimeter using visual (flickering checkerboard pattern) and sound signal biofeedback, consisted of 10—15 sessions, 10—12 minutes each. All patients were examined before treatment cycle, immediately upon the end of the cycle, and also 1 and 3 months after it.  

   Results.  Preliminary results showed an increase in best corrected visual acuity (BCVA) from 0.41 ± 0.24 to 0.68 ± 0.27 (33.9 %), the photosensitivity of the retina in the fovea increased from 27.07 ± 3.90 to 29.8 ± 3.3 dB (10 %), fixation density in the central region from 59.80 ± 31.08 to 72.05 ± 34.5 %
(20.4 %) with its amplitude decreased by more than two times. After treatment, unstable central fixation changed to stable central fixation in all cases. With eccentric fixation, the fixation point shifted closer to the central region, and fixation characteristics improved in 75 % of cases. The obtained results retained throughout the observation period which lasted up to 3 months.

   Conclusion.  The proposed new treatment method of amblyopia with impaired fixation of various degrees proved to be effective and safe and can be recommended for use in pediatric patients.

   Purpose: to evaluate the degree of structural lesions of the microvasculature, depending on the stage and type of active ROP with optical coherence tomography (OCT) in angio-mode (OCTA).

   Material and methods. 63 premature infants (63 eyes) with active ROP were tested by OCT of the retina, of which 30 were tested by OCTA. Additionally, 10 premature infants (10 eyes) without signs of ROP were tested by OCTA. We assessed the area and perimeter of the foveal avascular zone (FAZ), the thickness of the retina in the fovea, the density of the superficial
and deep plexuses in the fovea and parafovea, the presence or absence of intraretinal, epiretinal and retinovitreal neovascular complexes.
   Results. We revealed gross structural and microvascular retinal pathology in children with ROP, which was more pronounced in children with an unfavorable course of the disease. Of these, the most affected were children with a shorter gestational period, i. e , more immature. In children with a favorable type of ROP course, a severe general condition has a serious impact on the child’s microvasculature state. The analysis of the correlation dependences of OCTA on the gestational age, stage and type of active ROP, showed a strong direct correlation between the retinal thickness in the fovea, the density of superficial plexus vessels in the fovea, the area and perimeter of the FAZ, on the one hand, and the course of the disease, which is crucial for the correct choice of management and treatment tactics.

   Conclusion. The OCTA data allow an objective assessment of the severity of the changes in the retinal vasculature, including its microcirculatory component. The data effectively supplement the clinical picture and help identifying the progressive course o f active ROP at the earliest stages of the pathological process, thereby contributing to timely treatment and good clinical and functional results.

   Purpose: to determine the acoustic characteristics ofvarious types o f tissue scarringfor the differentiation o f post-traumatic eyelid scars.
   Materials and methods. 67 patients aged 32 to 67 (mean age 47.2 ± 9.5) with post-traumatic eyelid scarring were examined by ultrasound
gray-scale B-scan of tissues in the SmallPart mode and echodensitometry (Voluson Е 8 GE). The duration of the post-traumatic period of all patients was more than 12 months.

   Results. Objective echographic criteria for quantitative assessing the formed scar tissue of the eyelids were developed, which helped determine the acoustic criteria for various types o f post-traumatic scars (normotrophic, atrophic, hypertrophic and keloid) and to supplement the existing clinical classification with echographic data.

   Conclusion. Comprehensive ultrasound examination, which includes, tissue echodensitometry, along with B-scanning, is a highly informative method for the differential diagnosis ofvarious types of tissue scarring after eyelid injury.

   Purpose.  To compare the results of IOP measurement by the TVGD-02 transpalpebral tonometer (EASYTON) and the Goldman to­ nometer in ethnic Asians of Kazakhstan in order to assess the influence of epicanthus on the results of transpalberal tonometry.

   Material and methods.  A total of 150 patients (150 eyes) aged 39 to 65years were examined, including 120 patients (120 eyes) with primary open-angle glaucoma (POAG), and 30 patients (30 eyes) with high astigmatism and no POAG. All patients had their (IOP) measuredfirst with a Goldman tonometer, and then with a TVGD-02 transpalpebral tonometer (EASYTON). The correlation between the two methods was determined by the Pearson correlation coefficient.

   Results.  According to the EASYTON tonometer, the average IOP over the whole group was 20.20 ± 0.45 mm Hg, whilst the respective figure for the Goldman tonometer was 19.90 ± 0.43 mm Hg, the difference being statistically insignificant (p>0.05). In both groups and in varied IOP ranges the results of Easyton and Goldman tonometer data were comparable. No peculiarities in IOP mea­ surements taken from patients with epicanthus have been revealed.  

   Conclusion.  The absence of statistically significant differences between the data obtained by EASYTON and the Goldman tonometer in Asians implies that epicanthus does not affect the results of transpalpebral tonometry. The EASYTON tonometer may be considered an effective screening device in routine clinical practice. It is easy to use and can be recommended to ophthalmologists, general practitioners, nurses, optometrists, as well as glaucoma patients for IOP monitoring at home.

   Purpose:  a comparative study of the elemental composition of scleral biopsy specimens from patients with various clinical forms of glaucoma.

   Material and methods.  44 patients aged 79.5 ± 2.5 were divided into three groups depending on the form of glaucoma: 16 patients with primary open-angle glaucoma (POAG) (group 1); 13 patients with normal tension glaucoma (NTG) (group 2); 15 patients with pseudoexfoliative glaucoma (PEG) (group 3). For elemental analysis, we used scleral biopsies obtained during planned surgical treatment of glaucoma (non-penetrating sinus trabeculectomy). Scleral fragments of 14 donor eyes with no history of glaucoma served as controls. The concentration of macroelements K, Mg, Ca, and Fe was determined using inductively coupled plasma atomic emission spectrometry (ICP-AES, Agilent ICP-AES 720 ES, USA), while microelement concentration (Zn, Cu, Al, Mn) was measured using inductively coupled plasma mass spectrometry (ICP-MS, Bruker ICP-M S 820, Germany).

   Results.  In all forms of glaucoma, scleral samples showed a varying increase in the content of such elements as Zn, Fe, Mg, AL, Ca, K. The highest content of Zn and Fe was found in the scleral tissue of patients with NTG, the difference with the control (p = 0.0001 andp = 0.0003) and with POAG (p = 0.0002, p = 0.0001) being highly significant. The difference between the content of Zn in scleral biopsies of patients with POAG and PEG was also statistically significant (p = 0.0002), whilst no significant difference in Fe content in the sclera (p = 0.69) was found between POAG and PEG Higher Mg concentrations as compared to the control were found in NTG (p = 0.00014) and POAG (p = 0.00002).Patients with POAG (p = 0.0005) and PEG (p = 0.00022) showed the highest accumulation of Ca in the sclera. No differences were found in Mg content of scleral biopsies between patients with NTG and POAG (p = 1.0), while the level of Ca in POAG (p = 0.02) and PEG (p = 0.00001) was significantly higher than in NTG. A significantly lower content of Cu was found in the sclera samples of patients with NTG (p = 0.022), POAG (p = 0.004) and PEG (p = 0.00004) as compared to the control, as well as a reduced content of Mn in POAG (p = 0.00003) and PEG (p = 0.0012). Contrarywise, NTG patients showed an increased content of Mn (p = 0.000003). No differences were found in the Cu content between the sclera of patients with NTG and POAG (p = 0.47), while Cu level in PEG was significantly lower than in POAG (p = 0.034) and NTG (p = 0.013).
   Conclusion.  The macro- and microelement imbalance of the sclera of the eyes with different forms of glaucoma indicates differences in their pathogenesis. This can be the reason for the different severity of disorders of collagen biosynthesis and the formation of cross-links in the connective tissue structures of the sclera, as well as the varying degree changes in the hydrodynamics of the intraocular fluid, which on the whole can affect the level of intraocular pressure and the pattern of glaucoma development.

   A case report is presented of a film y form o f adenoviral epidemic keratoconjunctivitis (EKC) in an adult patient. The case is interesting in that the onset of EKC did not predict a complicated, hyperergic course of the condition, which ultimately led to cicatricial changes in the conjunctiva in the form of a partial external symblepharon. The ophthalmologists need to be on the alert for this form of EKC, which requires differential diagnosis, first of all, with true toxic diphtheria lesion of the conjunctiva. Adequate combined antiviral treatment of EKC using corticosteroids, immunomodulatory and symptomatic therapy helps to stop the process.

   In the treatment of patients with dry eye syndrome, the main measure is tear replacement therapy, the most accessible for practicing physicians. It is understandably based on the instillations of artificial tear medications, whose number is steadily growing. In Russia, there are 47 registered medications of this type. Considering the set of requirements for artificial tear medications (which are expected to moisturize the ocular surface, stop the hyperosmolarity of the tear film, ensure osmo-protection and reduce inflammation in the tissues of the ocular surface, as well as activate their reparative regeneration), the most promising medications are those containing two or more active ingredients. One such medication is Oftolik ® medium-viscosity tear substitute that contains a combination of 1.4 % polyvinyl alcohol and 0.6 % polyvinylpyrrolidone. The moisturizing effect of these polymers is complemented by reparative regeneration stimulation (polyvinyl alcohol) and the production of endogenous interferon (polyvinylpyrrolidone). Multiple studies confirmed high clinical efficacy of the medication for the treatment of patients with the main pathogenetic types of dry eye syndrome, as well as its syndromal and secondary symptomatic forms (computer visual syndrome) and revealed. As these effects are achieved with no significant side effects, we can recommend Oftolik® and its preservative-free form Oftolik BK ® for wide clinical use.

   We present a brief description of acute retinal necrosis, a rare and severe condition that is accompanied by a rapid development of inflammatory and occlusive events in the retinal vasculature preceding peripheral necrotizing retinitis. Despite successful etiotropic conservative therapy, the disease is complicated by proliferative vitreoretinopathy with a high risk of retinal detachment, leading to irreversible loss of sight. We present a clinical case of acute retinal necrosis in a patient with one seeing eye who experienced a reactivation of herpes simplex virus type 2 infection, discussing the treatment details and result.

   Angle-closure glaucoma diagnosis verification is based on biometric indicators and computer tomography data of the anterior segment of the eye. However, not every patient with a narrow angle and a shellow anterior chamber develops an acute attack. The review summarizes the literature data on risk factors for an acute glaucoma attack and lists additional parameters to be considered when examining patients with angle-closure glaucoma to identify a predisposition to an acute glaucoma attack.

   Scleral buckling was gold standard of surgical treatment of rhegmatogenous retinal detachment for more than half a century. This literary review is focused on the origin and development stages of scleral buckling surgery over the world.

   Systemic and ophthalmological diseases are on the rise the world over, which is, to a large extent, caused by life expectancy growth. Therefore, early diagnosis, screening and monitoringpossibilities of human health parameters is becoming more and more important. Contact lenses, due to being fitted on the eye’s surface, are constantly wetted by tear fluid, and due to present-day microelectronics achievements may be used as a convenient technical means for locating a variety of sensors. The existing prototypes of electronic contact lenses (ECL) are able to monitor intraocular pressure (IOP), levels of glucose, hormones and other biomarkers that reflect the presence of ophthalmic and systemic diseases. The review discusses the publications focused on prototyping results and first laboratory tests. As of today, only one developed device is available for clinical practice (IOP monitoring), others are at different stages of research but have all potentials for being used widely.