Purpose. To analyze the incidence of neoplasms of the eye and its appendages among residents of the Orenburg region, and determine its structure and dynamics within a 5-year period (2013 to 2017).

Material and methods. A retrospective analysis of morbidity of patients of the polyclinic and the 2nd ophthalmological department of Orenburg Regional Clinical Hospital No. 1 was performed for the patients aged 4 months to 90 years.

Results. Over the analyzed period (2013-2017) the incidence of oncological diseases of the eye and adnexa fell by 42 %. On the other hand, the share of malignant neoplasms increased by 40.3 %. On the whole, out-patients with neoplasms showed 68.6 % of basal cell carcinomas and 31.4 % of other malignancies, while hospitalized patients showed 58 % of basal cell carcinomas, 23.7 % of uveal melanomas and 18.3 % of other malignancies. Oncopathology of the eye and adnexa was found to affect women twice as often as men.

Conclusion. The obtained results may be used to assess the changes of the morbidity for Orenburg region in prospective and retrospective aspects, as well as assess, by extrapolation, the incidence of the pathology under study in other Russian areas.

Purpose: to study long-term (over a 60 months’ follow-up period) results of anti-VEGF therapy for macular diseases in real clinical practice.

Materials and methods. We undertook a single-center retrospective uncontrolled cohort study of 169 patients (109 women, 60 men) who received anti-VEGF therapy for eye diseases (ranibizumab, aflibercept). The treatment started between May 2010 and August 2015. The study group included 57 patients who remained under regular observation for 60 months. Of these, 24 cases had “wet” age-related macular degeneration (wAMD), 20 cases had myopic choroidal neovascularization, 10 had macular edema due to retinal vein occlusions and 3 had diabetic macular edema. The remaining 112 patients whose follow-up was discontinued made up the comparison group. We analyzed the dynamic results of clinical and instrumental examination in both groups, as well as data from a phone survey among the comparison group about the reasons for the termination of clinical observation. Statistical analysis of demographic data and treatment results was carried out using the Statistica 13.3 software. Conditions of normality for variables, nonparametric and parametric criteria were determined, and rank analysis of variance was carried out.

Results. The patients in the study group were significantly younger (p = 0.0029), had a higher initial (p = 0.0019) and final (p = 0.00027) best corrected visual acuity, and received a significantly greater number of intravitreal injections (p < 0.000001). In contrast, they had a significantly lower rate of therapy intensity factor (the ratio of injections number to the duration of observation in months) over the treatment period (p < 0.000001). In addition, the study group had a significantly lower proportion of men (p = 0.041) and patients with wAMD (p = 0.0010). The reasons for the termination of observation in the comparison group given in the phone survey, were as follows: stopped regular observation / treatment — 57 people (50.9 %), continue treatment in a different clinic — 3 (2.7 %), died — 13 (11.6 %), status unknown — 39 (34.8 %).

Conclusion. The data of the main morphological and functional results of treatment of the study group patients, discussion and conclusions will be presented in the second part of this article.

Purpose: to analyze the results of repeated micropulse transscleral cyclophotocoagulation (mTSCPC) in the treatment of refractory glaucoma (RG).

Material and methods. We examined 74 patients aged 73.2 ± 6.3 years with developed (13), advanced (48) and terminal (13) stages of refractory glaucoma before and within 15 months after the first mTSCPC (SUPRA 810, Quantel Medical, France) using standard laser parameters — 100 J. According to indications, the repeated mTSCPC was performed for 17 patients. Of these, 4 patients had the second procedure three months after the first procedure, 10 patients — 6 months after it, and 3 patients, 9 months after the first procedure. The repeated mTSCPC was performed with an impact energy higher than the first one — 125 J.

Results. After the first procedure, the hypotensive effect was held in 57 patients with RG (77.0 %) up to 15 months of the follow-up. The repeated mTSCPC given to 17 patients made it possible to reduce intraocular pressure (IOP) by 38.5 % for the developed RG stage, by 33.9 % for the advanced stage, and by 21.4 % at the terminal stage (p < 0.05) by 6–12 months of follow-up. The hypotensive effect was held in 13 out of 17 patients by the end of the follow-up.

Сonclusion. Single and repeated mTSCPC with laser energies of 100 J and 125 J are effective and safe techniques of RH treatment. Possibly, it is worth revising the basic parameters of the mTSCPC procedure from 100 to 125 J to achieve a longer and at the same time safe hypotensive effect in patients with RG.

Purpose: to analyze clinical and functional manifestations and the course of different stages of primary congenital glaucoma (CG) at different times of the disease onset, using the data of admissions to the Department of Eye Pathology in Children of the Helmholtz Research Center of Eye Diseases.

Material and methods. 191 patients (320 eyes) with CG, of which 113 were children (191) eyes with primary congenital glaucoma (PCG) aged 1 month to 16 years, underwent standard ophthalmological examination (autorefractometry, visometry, biomicroscopy, ophthalmoscopy), electrophysiological examination (flash VEP, ganzfeld and flicker ERG) and echobiometry (axial eye length measurement).

Results. A detailed clinical and functional characteristic of PCG, including structural and functional changes occurring at different stages. Most children with PСG showed advanced stages of the glaucomatous process: in cases where PСG was detected by 1 month of life, the advanced stages claimed 71.1 %, whilst the children diagnosed with PCG between 1 and 12 months of age, the advanced stages were found in 91.2 %. clinical manifestations were found to have variability, not always corresponding to the stages of the disease. In particular, we detected a correlation between disease progression and decreased VEP amplitude (p < 0.05), while no such correlation was found with respet to ERG parameters and VEP latency.

Conclusion. Despite the fact that PCG is detected comparative early, the destructive glaucomatous eye damage leads to severe and often irreversible consequences. The timing of CG manifestation is determined by the degree of congenital abnormalities in the eye drainage system that, together with secondary structural changes of eyes (cornea, axial length, retina and ONH) entail a more severe prognosis of PCG in case of an early disease onset. New objective criteria are needed to assess the severity and prognosis of PCG, which is important for the preservation of visual functions, prevention of low vision and blindness.

Purpose: a comparative estimation of ultrasound examinations of the posterior eye pole of patients with a macular hole using a long-focus high-frequency (20 MHz) and a standard 10 MHz probe with optical coherence tomography (OCT).

Materials and methods. 20 patients with a macular hole in at least one eye were examined using OCT of the macular area and B-mode echography with a standard 10 MHz probe and a long-focus high-frequency 20 MHz probe.

Results. The complex OCT/ ultrasound examination detected a macular hole in 22 (100 %) eyes, while OCT alone confirmed the diagnosis in 20 eyes (91 %). OCT could not be performed in 2 eyes due to a dense cataract. Ultrasound examination with a 20-MHz probe detected a macular hole in 16 eyes (73 %), whilst the standard ultrasound method (10 MHz probe) could only detect it in 10 eyes (45 %).

Conclusion. High-frequency ultrasound examination of the eye can be used for screening aimed at detecting a possible macular hole in cases of opacities of the optical media of the eye.

The Navilas 577 laser system integrates a laser coagulator with a tracking system and a fundus camera. The system ensures operation planning and representing the results of optical coherence tomography on the fundus image, which makes the treatment fast, clearly observable and safe and minimizes damage to healthy tissues.

Purpose. To compare the results of threshold laser coagulation in the treatment of DME using a Navilas 577 laser and a Quantel Medical 532 nm device.

Materials and methods. 64 patients aged 41–80 (64 eyes) with DME less than 350 μm high were examined after intravitreal administration of angiogenesis inhibitors and threshold lattice laser coagulation using Quantel Medical 532 and Navilas 577.

Results. A lower height of the edema and an increase in visual acuity were observed in both cases, but in the Navilas 577 laser group the BCVA was higher than in Quantel Madical 532, whilst the edema height in the Navilas 577 laser group in the central fovea area was less high.

Conclusion. 1. The combination of retinal laser coagulation and angiogenesis inhibitors in the treatment of low DME (less than 350 μm) provides good results, so it can be justified and expedient in real clinical practice. The efficiency of 577 nm navigation laser exposure was found to be higher than that of threshold 532 nm laser coagulation.

Purpose: an analysis of clinical and morphofunctional changes of the retina in high myopia combined with age-related macular degeneration (AMD) of various stages.

Materials and methods. We examined 45 patients (87 eyes, mean age 60 years) with high myopia (ave. spherical equivalent (SE) of refraction -11.0 D [-15.0; -7.125]) and the “dry” form of AMD, categories AREDS 1, 2, 3. Additionally, we formed three control groups of the same age range:  group 1 consisted of 30 healthy subjects (58 eyes) with a SE between -0.25 D and +0.5 D and no retinal changes; group 2 included 20 patients (38 eyes) with isolated high myopia (SE +0.5 D and no retinal changes; group 2 included 20 patients (38 eyes) with isolated high myopia (SE ³ 6.5 D) and group 3 included another 20 patients (36 eyes) with the “dry” AMD form (AREDS 2, 3). We evaluated the best corrected visual acuity (BCVA), indicators of retinal photosensitivity (MD, PSD) according to computer perimetry data, and morphological characteristics: central retinal thickness (CRT), the anteroposterior axis of the eyeball, the condition of the macular region of the retina according to optical coherence tomography (OCT) in the β-scan mode and autofluorescence (AF).

Results: in case of the combined pathology, we detected a reliable reduction of average BCVA to the level of 0.5 [0.3; 0.7] (p < 0.001) and a reduced factor of retinal photosensitivity as compared to the control: MD to -4.36 dB (р<0.001), PSD to 2.97 dB (р < 0.001). CRT was 235 μm (p = 0.122), which showed no statistically significant differences to the control. Morphological changes of the retina corresponded to high myopia and AMD: a dome-shaped profile, lacquer cracks, paravascular retinal microcysts, paravascular lamellar ruptures; myopic maculopathy in the form of an epiretinal membrane, vitreomacular traction due to incomplete vitreoretinal cleavage, myopic foveoshisis; patchy chorioretinal atrophy, areas of diffuse RPE atrophy, damage of the junction line of the outer and inner segments of photoreceptors. The increase in the number and size of drusen depended on the stage of AMD. Normal autofluorescence of the fundus was absent. Pathological AF included minimal changes patterned as focal hypo- and hyperautofluorescence, reticular pattern, focal pattern, linear pattern, lace-like pattern, areas of geographic atrophy with pronounced hypoautofluorescence.

Conclusion. Changes in OCT and visual field parameters (MD, PSD) in comorbid pathology (AMD combined with high myopia) were revealed. The morphofunctional indicators were compared for different AMD stages, and the diagnostic significance of AF was established.

Purpose: a comparative study of the efficacy and safety of the generic drug Dorzial Plus, an analogue of the original reference drug Cosopt®, in patients with primary open-angle glaucoma (POAG).

Material and methods. The study involved 80 patients of both sexes aged 55–75 with newly diagnosed POAG of the initial and advanced stages with uncompensated intraocular pressure (IOP), of which 40 patients (study group) received Dorzial Plus and 40 patients (comparison group) received the reference drug (Cosopt®). Hypotensive efficacy of the drugs in both groups was assessed using a portable ophthalmic tonometer Icare PRO (Finland) by reducing IOP from the initial level after 1 week, 1 month and 3 months of treatment.

Results. In both groups, the screening showed comparable average IOP values: 26.7 ± 3.2 mm Hg in the reference drug group and 27.4 ± 2.8 mm Hg in the Dorzial Plus group. After 1 week of therapy with Cosopt, IOP showed a significant decrease of 33% (reduction to 17.9 ± 3.2 mm Hg), while the group receiving Dorzial Plus demonstrated a 31% decrease (reduction to 18.9 ± 1.7 mm Hg). After 1 month of the instillation regimen, a slight increase in P0 (of about 3%) was recorded in both groups (increase to 18.7 ± 2.3 and 19.7 ± 2.0 mm Hg, respectively). By the end of the 3 months’ follow-up period, IOP decrease level with respect to the baseline remained practically the same, amounting to 30 and 29% (up to 18.6 ± 1.8 and 19.5 ± 2.3 mm Hg), respectively. The state of the ocular surface showed a slightly negative dynamics of tear film rupture time and OSDI index in the reference drug group, which could be observed throughout 3 months of therapy. In the study group, therapy with preservative-free drug containing a moisturizing agent (sodium hyaluronate) revealed a significantly changed OSDI index, manifesting itself in restructured severity of the evaluated features.

Conclusion. Dorzial Plus reduces IOP in POAG patients by an average of 30% of the baseline, so that its hypotensive efficacy is comparable to the original fixed combination Cosopt. The tolerability analysis of the study drug demonstrates a significant positive dynamic of the state of the ocular surface as soon as 3 months after therapy start.

Long-term hypotensive effect in the postoperative period is one of the main tasks of modern glaucoma surgery.

Purpose. To develop new modifications of sinus trabeculectomy in the surgical treatment of primary open-angle glaucoma (POAG), aimed at reducing scarring, normalization and prolongation of the outflow of intraocular fluid along newly formed pathways.

Material and methods. During the first operation, a superficial scleral flap was formed. After trabeculectomy, the scleral flap was twisted by 180° in the middle, then fixed with sutures to the sclera. During the second operation, after the formation of the superficial scleral flap, and the trabeculectomy, the scleral flap was stitched in the middle and assembled in such a way that its width decreased by 1/3–1/2, after which it was fixed with sutures to the sclera. The operation was performed on 84 patients (84 eyes) aged 43 to 86 years (mean age 63.12 ± 1.17). Of these, 59 patients had POAG in advanced and far advanced stages, and 25 patients had a history of previous laser and surgical POAG interventions. The patients were divided into groups: 1a — 28 patients (28 eyes) who underwent sinus trabeculectomy with twisting the scleral flap, 1b — 29 patients (29 eyes) who underwent sinus trabeculectomy with stitching of the scleral flap and the control group – 27 patients (27 eyes) who underwent standard sinus trabeculectomy. The follow-up lasted 24 months. Standard methods (visometry, tonometry, computer perimetry, tonography, etc.) were used in the pre-surgical and post-surgical examination. In addition, we performed, in the early postoperative period, optical coherence tomography of the anterior eye segment followed by ultrasound biomicroscopy.

Results. 1 month after surgery, the average IOP levels were simliar and remained low in all groups: 1a — 16.1 ± 0.5 mmHg, 1b — 16.4 ± 0.8 mmHg, 2 — 17.1 ± 0.7 mmHg. By the 1st year of the study, normalized IOP was maintained in both the two main groups and the control group. By 24 months of the follow-up, the effect was retained in 82.1 % in group 1a and in 82.7 % in group 1b. If the patients were IOP compensated with  medication, the effect rose to reach 92.8 % and 96.4 %. In the control group, the hypotensive success rate was 74 %, if patients IOP were compensated with medication it rose to 88.8 %.

Conclusion. The developed new methods of sinus trabeculectomy for surgical treatment of glaucoma ensures a prolonged hypotensive effect.

Purpose: to evaluate the effectiveness and safety of combination therapy using the moisturizing ophthalmic solution, Hyloparin-Comod®, and the lubricating ophthalmic agent Parin-Pos® in complex medical management in the early stages after reconstructive interventions on the auxiliary apparatus of the eye.

Material and methods. The clinical group consisted of 30 patients (40 eyes) aged 18 to 75 (m = 58.46 ± 7.31), of which 7 (23.3 %) were men; and 23 (74.7 %) women. Of these, 18 patients had ptosis of the upper eyelid (of which 10 had bilateral ptosis), 8 had inversion of the eyelids and 4 had eversion. All patients underwent reconstructive plastic surgery on the auxiliary apparatus of the eye: ptosis of the upper eyelid was treated by various methods depending on its type: 18 patients received plastic surgery of the levator aponeurosis (in 8 cases on both eyes; simultaneously, blepharochalasis resection was performed), 4 patients underwent levator shortening, 4 patients underwent eyebrow suspension (of these, 2 patients had the procedure on both eyes, hanging to the eyebrow – 4 operations (both eyes were operated on in two patients), 2 had tarzomyectomy; 8 had elimination of inversion, and 4 had elimination of eversion. In the postoperative period, instillations of antiseptics and antibiotics were supplemented by tear replacement and keratoprotective therapy: Hyloparin-Comod® was instilled 3 times during the day, while Parin-Pos® ointment was placed under and on the eyelids before going to bed. The course of treatment lasted 1 month. All patients underwent a standard ophthalmological examination before surgery as well as 2 weeks, 1 month and 3 months after surgery. The criteria for evaluating the effectiveness of treatment were the condition of the eyelid skin on a pointwise scale (Manchester scar scale), the result of biomicroscopy / biomicroscopy with fluorescein staining of the conjunctiva and cornea, Norn test.

Results. In all cases of the use of Hyloparin-Comod® and Parin-Pos® combination, good subjective tolerability was noted, the patients had no complaints of discomfort due to the use of drops or ointment.

Conclusion. The results obtained demonstrate that the proposed combination of drugs contributes to improving the favorable condition of eyelid skin and wound healing with the formation of a delicate scar, rapid resolution of conjunctival and eyelid swelling, prevention of corneal microerosions, minimization of corneal epithelial edema and tear film stability.

Purpose. To analyze optical and biometric indicators of children's eyes with various stages of congenital juvenile glaucoma (CJG) combined with myopia.

Material and methods. We examined 17 patients (31 eyes) aged 11 to 17 (averagely 14.0 ± 0.2 years) diagnosed with CYG who underwent, prior to surgical or conservative treatment, a regular ophthalmological examination supplemented with the measurement of the central corneal thickness (on an automatic contactless tonometer-pachymeter by NIDEK, USA), and the index of corneal deformation (ICD) by the Shkrebets technique.

Results. The analysis showed a possible correlation between 1) tonometric intraocular pressure (Pt) and the axial length of the eye, 2) Pt and the ratio of excavation to optic disk diameter (E/ON), 3) axial length of the eye and the central corneal thickness at the terminal CYG stage, and 4) the axial length and the refraction at the initial stage of CYG.

Conclusion. As the glaucomatous process progresses, children with CYG combined with myopia show an increase of myopic refraction, a decrease in fibrous membrane rigidity, pretrabecular and trabecular changes, axial elongation, increased IOP due to an imbalance between the production of intraocular fluid and its outflow, an expansion of the excavation of the optic disk and a decrease in the central corneal thickness.

Diabetic retinopathy (DR) is one of the severe complications of diabetes mellitus (DM). Despite the multiyear research of DR pathogenesis, the role of the vitreous body in DR development has not been sufficiently studied. Purpose: to demonstrate the potentials of multispiral computer tomography for assessing the density of the vitreous body in patients with type I diabetes.

Material and methods. 97 practically healthy individuals (the control group) and 137 patients with type I diabetes (the main group), aged 10 to 35, were tested by multispiral computer tomography to assess their vitreous density.

Results. DM type I patients showed a higher vitreous body density in the central and preretinal areas than healthy individuals. The two observation groups showed a statistically significant difference in the level of glycemia only, whilst no reliable difference in lipid metabolism was revealed.

Conclusion. Multispiral computer tomography is a sufficiently sensitive testing method which allows registering even minor differences in the density of the main components of the vitreous body between healthy people and patients with type I diabetes. The higher density of the vitreous body in type I DM patients is probably associated with a higher level of glycosylation.

Purpose: to study the concentration of vascular endothelial growth factor (VEGF A) in the tear fluid (TF) of patients with primary open-angle glaucoma after non-penetrating deep sclerectomy (NPDS) at different stages of the perioperative period and to perform immunohistochemical identification of the lymphatic structures of filtering blebs in groups differing in the hypotensive effect of the surgery.

Material and methods. 12 months after surgery, POAG patients were divided into 2 groups. Group 1 was composed of patients who experienced a hypotensive effect after NPDS (n = 23; mean age 63.7 ± 4.4 years), while group 2 had no such effect of NPDS (n = 21, mean age 64.3 ± 3.9 years). The concentration of VEGF A (121 and 165) in TF was determined by ELISA method (VEGF-ELISA-Best, Vector Best, Russia). Immunohistochemical examination of conjunctival and subconjunctival tissue samples was performed 12 to 18 months after NPDS in 12 POAG patients and 8 patients aged 62.36 ± 6,31 with no glaucoma, which served as a control group.

Results. Significant differences in the concentration of VEGF A (121 and 165) in TF were found in two groups 2 weeks and 2 months after the surgery. Excessive scarring of filtering blebs was accompanied by an initially low level of VEGF A, its moderate increase 2 weeks after surgery and significant suppression 2 months after surgery, which was significantly different from group 1 (a twofold VEGF A increase has been established toward the second month after surgery). From 5 to 7 vessels with lymphatic character were found in tissue samples of group 1. Podoplanin was found in individual cells and sphere-like formations, which may represent reduced lymphatic vessels.

Conclusion. The study showed an important role of VEGF A in conjunctival lymphangiogenesis. Suppression of conjunctival lymphangiogenesis and subsequent “hypotensive failure” of glaucoma surgery in some patients who underwent anti-inflammatory and antifibrosis therapy requires optimization, the development of new treatment methods aimed at activating prolymphangiogenic factors.

Purpose: to study the impact of diagnostic ultrasound of high acoustic power on animal eye tissues in the experiment.

Material and methods. 46 Chinchilla rabbits (92 eyes) were divided into the main group of 38 rabbits (76 eyes) and the control group of 8 rabbits (16 intact eyes). Animals of the main group were exposed for 30 minutes, through closed eyes, to high-intensity ultrasound (MI 0.9–1.0, TI 1.5–2.0, Ispta.3 50 mW/cm²) by colour Doppler imaging and pulsed Doppler. All animals of this group had corneal thickness measured by optical coherence tomography (OCT) before and immediately after exposure to ultrasound (20 rabbits) and also 2 weeks later (18 rabbits). During the same time span, the content of heat shock proteins HSP27 (HSPB1), HSP60 (HSPD1) and inflammatory mediators: monocytic chemotactic protein-1 (MCP-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) in blood serum and vitreous was determined. Histopathological examinations of the enucleated eyes of rabbits with morphological and morphometric assessment of retinal tissues were performed on the 1st day and 2 weeks after exposure to ultrasound.

Results. Immediately after ultrasound exposure and 2 weeks later OCT data reflected no structural changes in the cornea. Quantitative assessment of the levels of HSPD1, HSPB1, MCP-1, IL-6 and IL-8 in blood serum and vitreous did not reveal statistically significant changes after ultrasound exposure. A morphological study including an assessment of morphometric characteristics revealed the absence of apoptotic changes in the layers of the retina at different times after exposure to high-intensity ultrasound.

Conclusions. We established no immediate or delayed bioeffects of high acoustic power diagnostic ultrasound exposure lasting up to 30 minutes on the biological media and ocular tissues of animals.

Purpose: to investigate the changes of electrophysiological activity of healthy rabbit retina occurring in courses of fractal stimulation (FS) of varied duration in order to obtain new scientific data on how fractal visual signals of low intensity, self-similar with respect to time, affect the retina.

Material and methods. 12 healthy Chinchilla rabbits (24 eyes), were examined before and after FS courses that lasted 1, 4 or 12 weeks, using electroretinographic (ERG), morphometric (optical coherence tomography) and biochemical methods (detection of dopamine in the tear). For FS of rabbits, a device with an LED emitter was developed, which generates nonlinear brightness fluctuation based on the Weierstrass — Mandelbrot fractal functions. The choice of fractal signal parameters used in the work was substantiated. Pattern ERG and ganzfeld ERG were registered according to ISCEV standards; also, photopic flicker ERG was recorded at 8.3, 10, 12, and 24 Hz.

Results. No negative effects of a 12-month FS course on the activity and morphology of the retina, or on dopaminergic processes in the eye of a healthy animal were found, which confirms the safety of using low-intensity FS in the clinic. A statistically significant increase in the amplitude of low-frequency flicker ERGs, a shortening of peak latency, and an increase in the amplitude of the b-wave of the scotopic and photopic ERGs was noted.

Conclusion. To assess possible therapeutic effects of FS, we need to continue the investigation on animal models and human patients with retinal pathology. Considering the changes of retinal activity as revealed in the present paper, we recommend the duration of FS courses from 1 week to 1 month for future studies.

Purpose. To assess the validity of alpha-2-macroglobulin ( 2-MG) activity and endothelin-1 (ET-1) concentration for the characterization of local metabolic disorders in experimental retinal pigment epithelium atrophy (RPE).

Material and methods. To reproduce RPE atrophy, 22 New Zealand Albino rabbits were given a subretinal injection of bevacizumab or saline. Tear fluid was collected before the injection and 3 months after it. In the second series of the experiment, tear fluid was also collected on the 3rd, 7th, 14th, 21st and 28^th days after bevacizumab injection. Tear fluid was analyzed for the activity of 2-MG using the fermentation method and for ET-1 concentration by the immunoenzymatic method.

Results. 3 months after bevacizumab injection, 2-MG activity in the tear remained normal, while after saline injection it was, on average, twice as high as the initial one. ET-1 concentration showed a significant increase of over 1.5 times on the 3rd day after bevacizumab injection both in the tear of the operated and the contralateral eyes.

Conclusion. Subretinal bevacizumab injection had no significant lasting damaging effect on the retina, as opposed to saline injection that led to an increase of 2-MG activity in the tear. A transitory increase of ET-1 concentration in the tears after bevacizumab injection may indicate vascular tone elevation in the eye during this period. The study of 2-MG activity and ET-1 concentration in the tear may be used to monitor local metabolic shifts in experimental RPE atrophy development, as well as to assess the post-transplantation process and therapy adequacy.

Purpose: to evaluate the topical use effect of angiotensin-converting enzyme (ACE) inhibitor (iACE) Enalaprilat in eye drops on eye blood flow volume, hypoxia degree, ACE activity, and total antioxidant activity (TAA) in aqueous humor of rabbits with experimental ocular ischemia.

Material and methods. Transient ocular ischemia in 30 Chinchilla rabbits was induced by subconjunctivally injecting 0.2 ml of 1 % Phenylephrine. Ocular ischemia degree was assessed by the minute volume of blood flow (MBF), determined with the help of ophthalmic plethysmography. 0.125 % Enalaprilat was administered by instillations. A CE activity in aqueous humor was measured using a spectrofluorometric assay with 0.1 mM Z-Phe-His-Leu substrate; the degree of hypoxia was estimated by the level of lactate in aqueous humor, which was determined by the enzymatic amperometric method. TAA was determined by registering chemiluminescence kinetics in the hemoglobin-H2O2-luminol model system.

Results. A single instillation of iACE in the intact rabbit eye caused a decline of MBF value and A CE activity in aqueous humor. In ocular ischemia, ACE activity and t he lactate level in aqueous humor are increasing, while TAA is decreasing. Enalaprilat instillation in the eyes with ischemia lead to the normalization of MBF, ACE activity, lactate level and TAA in aqueous humor.

Conclusion. Topical iACE in eye drops can penetrate eye tissues. Instillations of iACE during ischemia cause a remarkable increase of eye blood flow and reduce ACE activity, which is increased in ischemia. The anti-ischemic effect of iACE is accompanied by antihypoxant and antioxidant effects. Thus, iACE in eye drops can be used in ophthalmology as an anti-ischemic agent.

Purpose: to evaluate the results of corneal ultraviolet (UVA) crosslinking used in the complex treatment of recurrent corneal ulcer in a child. Patient K., 6, was treated in the department of children eye pathology with the diagnosis of corneal ulcer. The case history said the patient was sick for 2 years, periods of remission alternated with exacerbation. Immunological examination revealed sensitization to herpes simplex virus types 1 and 2 (IgG = 3.2 with the norm of < 0.18). The combined treatment included drug therapy and local UVA crosslinking of the cornea (7 procedures per 6 minutes every other day). Optical coherence tomography showed positive changes during treatment: the depth and area of cornea infiltrate became smaller. 1 month after the last procedure, the inflammatory process was stopped and the corneal clarity gradually restored whilst vascular activity became less intense. After 2 months, the infiltrate area became clear throughout. OCT revealed a gradual decrease of the infiltrate thickness and a replacement of the cornea with a transparent tissue.

Conclusion. Local corneal UV-crosslinking used as part of the complex treatment of keratitis and corneal ulcers in children is a very promising method for implementation in clinical practice.

Purpose: to describe surgical treatment of glaucoma of a patient with Sturge — Weber — Krabbe syndrome. We present a clinical case of a patient with Sturge — Weber — Krabbe syndrome who sought assistance with us due to secondary stage III glaucoma with moderately elevated intraocular pressure. The examination revealed a cutaneous hemangioma of the frontal, and zygomatic area of the left half of the face, the upper and the lower eyelids, and conjunctival and episcleral hemangioma of the left eye. Since local hypotensive drug therapy produced no effect, the patient was offered a surgical treatment: sinus trabeculectomy. A pronounced hemorrhage from the conjunctival vessels, the episclera and choroidal vessels that occurred during the operation increased its duration, but severe complications could be avoided. A hyphema that appeared during the operation was almost completely washed out and dissolved within 5 days. Since scarring processes of the filtration zone were activated in the postoperative period, we resorted to an active tactics of the patient’s management, namely the needling of the filtration zone with the use of antimetabolites and corticosteroids.

Conclusion. Sinus trabeculectomy is an effective method of IOP normalization in glaucoma patients with Sturge — Weber — Krabbe syndrome. Active management of the patient in the postoperative period of the case described allowed us to avoid severe intra- and postoperative complications and to achieve stable clinical and functional results.

Cavernous hemangioma of the orbit (CHO) is a vascular space-occupying lesion that develops as a result of an abnormal anlage of the vascular system and occurs in 70% of patients with vascular neoplasms of the orbit. CHO is more often considered as a venous malformation with slow blood flow, rather than a benign tumor. Very rarely CHO spreads into the cranial cavity, usually through the upper orbital fissure and the optic canal. The recurrence of CHO after its complete removal is low, however no reliable data are available. It is supposed that CHO relapse can occur in three cases: the continued growth of an incompletely removed tumor, growth of an undiagnosed space-occupying formation, and the emergence of a new tumor. The purpose of the study is to present a clinical case of a multiple recurrence of orbitocranial cavernous hemangioma. The clinical case demonstrates such a recurrence after an incomplete CHO removal, which was manifested by exophthalmos and moderate oculomotor disorders. Special features of the clinical case also include CHO spread into the cranial cavity accompanied by a cavernous hemangioma of the brain structure.

Purpose. To develop a classification of meibomitis accounting for the diverse course and stages of progression and offer guidelines for treatment based on the algorithm proposed.

Materials and methods. We observed 56 patients aged 4 to 68 (average age 33 years), of which 42 patients (75 %) were followed up for periods from 3 to 60 days. The patients received basic complex conservative treatment, probing the meibomian gland with an eyelash during the acute inflammation and microabscess stage, in the presence of the chalazion with and without inflammation manifestations, and underwent drainage of the microabscess or the chalazion according to the classification.

Results. The proposed algorithm reduced the duration of meibomitis treatment. Relapses were only noted in 2 cases; one case was complicated by corneal erosion caused by hardened oil. No complications associated with the treatment have been noted and nobody was prescribed surgical removal of the chalazion.

Conclusion. A meibomitis classification with effective combined treatment has been proposed, which is convenient for practitioners, cost-effective and not requiring special instruments or materials.

Reduction of intraocular pressure is currently considered as the main strategy to stop or slow down the progression of glaucomatous optic neuropathy. However, this goal is achieved in only 1 in 7 patients with primary open-angle glaucoma (POAG). Therefore, it is important to determine further risk factors that can be therapeutically influenced. One example of such risk factors is lipid metabolism disorders. Material and methods. Literature search in PubMed using the queries “primary open-angle glaucoma” and “dyslipidemia” limiting oneself to the period from 2000 to 2021. Results. POAG is currently considered to be a systemic neurodegeneration with neuroinflammation at the forefront. Oxidized low density lipoprotein (oxLDL) acts as a free radical (so-called bioactive lipid) with pro-inflammatory properties and promotes glaucomatous neuroinflammation. Conclusion. In addition to a personalized targeted pressure-oriented intraocular pressure reduction, LDL-associated lipid metabolic disorders should be corrected in every POAG patient. LDL cholesterol below 100 mg/dl (2.6 mmol/l) in the blood is the critical threshold level.

The review presents a literature analysis on the life style and diet habits of patients with glaucoma. The issue is relevant due to the flow of versatile information in the media, including the Internet, which offers recommendations that lack evidence and may put patients at risk. The review summarizes recent studies on nutrition that take account the factors of glaucoma pathogenesis, physical activity recommendations, the regimens of sleep and rest, possible effects of simultaneous systemic and local use of β-adrenoblockers, and other life style factors essential for patients with glaucoma.

Recent years have seen an increase in tobacco mixture smokers using hookahs. Dangerous substances released during smoking cause substantial harm to the entire body, and bring about visual impairment with toxic optical neuropathy. Eye structures which are the most susceptible to toxin damage are the cells of the optic nerve and retina. Substances released when smoking hookah tobacco mixtures have a direct neurotoxic impact on the optic nerve and cause metabolic damage to the retinal nerve fiber layer and ganglion cells. Timely detection of this damage is complicated by the similarity of its clinical picture with other optic nerve diseases, which requires a thorough differential diagnosis.

The review presents modern possibilities of early diagnosis of glaucoma using optical coherence tomography (OCT), angio-OCT and microperimetry. We analyzed literature data for the last decade, focused on testing patients with suspected glaucoma or diagnosed with glaucoma, including its various stages. The data confirm the advantages of OCT, angio-OCT anf microperimetry, such as fast testing procedures, non-invasiveness, high informativeness, sensitivity and specificity of the methods, as well as real possibilities of early detection of glaucoma, which are especially promising if a combination of methods is used.