Purpose. To evaluate the effectiveness of control of myopia of various degrees in children and adolescents with the combined use of orthokeratology (OK) correction and ultralow-dose atropine instillations (0.01 %) over a long-term follow-up period (up to 3 years). Material and methods. Children and adolescents aged 11.0–13.5 with continuing progression of acquired myopia who wore nocturnal OK lens (OKL) were divided into three groups according to the duration of 0.01 % atropine application: group 1 comprised 58 children (116 eyes) who received the treatment for 6 months, group 2, 34 children (68 eyes), 8 months, group 3, 145 children (290 eyes), 36 months. The patients were examined before their OK-correction was supplemented by 0.01 % atropine instillations and every 6 months after it. The examination included visometry, refractometry, determination of reserves of relative accommodation reserve (RAR), objective accommodation response, pseudo accommodation (PA), measurement of axial length by optical biometry, anterior biomicroscopy, assessment of lens conditions; ophthalmoscopy under maximum mydriasis using binocular ophthalmoscope. Results. With atropine instillations, the yearly progression rate of myopia (YPR) in group 1 significantly decreased (by 1.6 times). the best effect showing in mild and moderate myopia. In group 2, after 18 months’ follow-up, YPR had significantly decreased (by 2.2 times). In group 3, after a 36 months’ observation, the maximum, 2.8-fold decrease in YPR was observed. The most marked and significant, 3.5-fold decrease in progression rate was observed in low myopia. In moderate myopia, the inhibitory effect of the combination of OKL/atropine combination showed a significant increase as the treatment duration became longer. In high myopia, progression rate fell insignificantly in the first 6 months, but over the whole period of observation, YPR showed a statistically significant, 1.6-fold decrease as compared to the initial level. RAR and PA remained at the levels they were before atropine instillations. Conclusion. OK correction combined with 0.01% atropine instillations produces a pronounced inhibitory effect in children with the most unfavourable course of myopia – progression continuing with night-time orthokeratology. The most pronounced effect was obtained in mild to moderate myopia. The longer the treatment period, the greater the effect of myopia stabilization. Over the 36 months’ period, 0.01% atropine showed no negative effect on the quality of visual functions of subjects wearing OK lenses.

Purpose: to assess the degree of parents’ compliance of children with retinopathy of prematurity (ROP) in the active phase of the disease and to identify the factors affecting the formation of the compliance. Material and methods. 73 parents (67 mothers and 6 fathers) of active phase ROP-patients were surveyed using a replenishable database created in Google Forms The respondents’ age ranged from 22 to 46 years (averagely, 32.5 ± 2.0 years). The questionnaire involved socio-demographic characteristics (the parents’ age and gender, place of residence, education; gestational age of the child at the time of birth, the child’ age at the moment of the parental survey) and the data on the communication with medical personnel and adherence to their recommendations. The survey had multiple choice and open-type questions. The criteria for compliance included exact adherence to the recommendations of the attending physician and the approval of their actions concerning the main treatment features (using of medications, resorting to surgery, i.e. laser coagulation of the retina, dynamic multi-stage ophthalmological observation). Results. 90.4 % of the respondents received basic information about the eye disease of their child from an ophthalmologist. 15.1 % of respondents mentioned additional printed sources, and 20.5 %, the Internet resources. High levels of satisfaction concerned the completeness of the information received from the doctor (76.7 %) and the appointment of diagnostic examinations and laser coagulation of the retina (100 %). The highest compliance rates were found in parents over 36 yrs. and in the parents of patients with severe posterior aggressive ROP. The level of education, place of residence, the degree of prematurity of the child had no significant impact on the assessment of the competence of the ophthalmologist. Conclusion. ROP has specific clinical and psychological features that require high professionalism, and communication skills of neonatologists and ophthalmologists. It is expedient that a clinical psychologist participates in the treatment process so as to ensure timely correction of compliance disorders of the parents of a premature infant.

Purpose: to describe the mechanisms of the therapeutic effect of platelet-rich plasma (PRP) components on the retina in macular hole (MH) surgery. Material and methods. The results of autologous PRP use in 36 cases of surgical treatment of eyes with idiopathic full-thickness MH sized 96 to 932 mm (ave. 546.4 ± 49.8 mm) are presented. Corrected visual acuity before surgery was 0.04 to 0.2 (0.09 ± 0.01). The quantity of cell elements in PRP fractions was determined using a hematological analyzer Sysmex XS-500i (Germany). Results: 2 months after the operation, all retinal layers in the MH area were found to restore in all patients, who showed an increase in visual acuity to 0.2–0.6 (0.40 ± 0.04). 35 patients (97 %) had no MH relapse over the 6-month post-surgery period. A technique was proposed to evaluate the quality of PRP by the presence of large platelets. The mechanisms of the therapeutic effect of PRP components on the retina were presented. Conclusion. The collection of data on the effectiveness of PRP components is instrumental in planning its wider use in the treatment of degenerative, infectious, post-traumatic and other disorders of eye structures. The evaluation of PRP quality by the content of functionally active platelets will also contribute to more effective PRP use in ophthalmology.

Purpose: to analyze the results of corneal astigmatism correction by cataract surgery using two methods of marking the calculated toric IOL axis with Alpins vector analysis. Materials and methods. The retrospective study group included 212 patients (259 eyes) with cataracts and baseline corneal astigmatism from 0.75 to 8.25 D. The patients were implanted with two varieties of toric IOLs: Alcon Acrysof Toric (113 patients, 135 eyes) and Zeiss AT Torbi 709M (99 patients, 124 eyes). IOL parameters were calculated using an IOLMaster 500 (Carl Zeiss) optical biometer, the target refraction being emmetropy. The axis of toric IOL alignment was determined by online calculators provided by the producers. The patients were divided into two groups in accordance with the marking method: group 1 patients (149 eyes) were marked using by the authors’ techniques that used the angular scale of the slit lamp, while group 2 (110 eyes) was treated with Verion (Alcon) and Callisto Eye (Zeiss) navigation systems. The effectiveness of astigmatism correction was assessed using the Alpins vector analysis method. Results. After surgery, both groups showed a significant increase in uncorrected (UCVA) and best corrected visual acuity (BCVA). In group 1, one month after the operation, the UCVA was 0.67 ± 0.19, and the BCVA was 0.80 ± 0.17. In group 2, UCVA was 0.69 ± 0,07, and BCVA was 0.80 ± 0.49. The success index (IOS) was 0.14 in group 1 and 0.11 in group 2. The difference vector (DV) in the two groups was 0.37 and 0.31 D, respectively, suggesting highly precise astigmatism correction. The average error angle (AOfE) in group 1 was 3.29°, and in group 2 — 3.29°. The average value of the TIA vector was 2.69 ± 1.01 D along the axis of 87.3°, in group 1, while that of group 2 was 2.75 ± 1.09 D along the axis of 95.1°. The average values of the SIA vector were 2.32 ± 0.99 D along the axis of 870 in group 1 and — 2.44 ± 1.03 D along the axis of 99.6° in group 2. Conclusion. The authors’ markup method using the angular scale of the slit lamp yields high functional results of corneal astigmatism correction. The comparative vector analysis of the two study groups shows similar results in applying the authors’ type of markup and that of intraoperative navigation systems.

Purpose. To analyze the level of endothelin-1 (ET-1) in the tear fluid (TF) of children with primary congenital glaucoma (PCG) and to detect possible correlations between the clinical and the laboratory data. Material and methods. We examined 23 eyes of 15 children with PCG aged between 7 months and 15 years and 3 healthy fellow eyes of these children. 25 eyes of children of same age without glaucoma (somatically healthy with mild hyperopia and/or concomitant strabismus) served as control. A standard ophthalmological examination was supplemented by the flash visual evoked cortical potential, a total and a rhythmic electroretinogram, axial length (AL) echobiometry of the eye, optical coherence tomography of the optic nerve head, enzyme immunoassay (ELISA) of ET-1 level in TF were given. Results. In most children with PCG (95.6 %), the TF level of ET-1 (mean 9.69 ± 3.80 pg/ml) was higher than that in healthy children (4.65 ± 2,02 pg/ml) (p < 0.001). Increased levels of ET-1 (up to 8.90 pg/ml) were also detected in healthy fellow eyes of children with PCG. The mean level of ET-1 in children with PCG aged 3 to 15 years was significantly higher (p< 0.05) lower than in the initial stage. Our study revealed no correlations between the ET-1 level and the degree of retinal nerve fiber layer thinning, or the AL in children with PCG. Conclusion. For the first time, an increased level of ET-1 in the TF in children with PCG was revealed as compared to healthy children. A lower value of ET-1 in the far advanced PCG stage as compared to the initial stage can be explained by long-term chronic eye tissue hypoxia depleting the protective reserves of the eye. Since no obvious correlation between ET-1 level in the TF and clinical and functional data of children with PVG has been found, we cannot definitely view the ET-1 level in the TF as a measure of ischemia degree in PCG. Further studies are needed to obtain reliable correlations.

Purpose: to analyze the clinical manifestations, course, and results of treatment of Coats disease in children. Materials and methods. We performed a retrospective analysis of medical records of 59 patients with Coats retinitis (83 % were boys) who had been comprehensively examined and treated between 2018 and 2021. After the diagnosis was verified, the children were hospitalized for treatment. Retinal laser coagulation was performed on 61 eyes, angiogenesis inhibitors were administered on 1 eye, and 5 eyes received microsurgical interventions. Results. At the time of disease detection, the children’s age varied from 1 to 16 years. In 97 % of cases, the process was unilateral. An improvement of the anatomical condition and the eye-preserving effect were achieved in 87 %. Visual acuity could only be increased in 19 eyes (31.1 %), all with the initial or the advanced stages of Coats retinitis. Proceeding from our experience, the analysis of polymorphism of clinical manifestations, functional prognosis and differentiated approach to treatment depending on the prevailing clinical symptoms, we suggest a new variant of clinical classification of Coats retinitis. Conclusion. In order to ensure a timely diagnosis of the disease, a very thorough examination of patients in the first decade of life is required. Only an early diagnosis and timely treatment can help achieve not only an eye-preserving effect but also functional results.

Purpose: to assess the efficacy of inhalation anesthesia with laryngeal mask in extremely premature infants with low or extremely low birthweight and somatic comorbidities during the surgery of retinopathy of prematurity (ROP) in the active phase of the disease. Materials and methods. 477 infants of 25 to 32 weeks’ gestational age were treated by delimiting retinal laser photocoagulation. Inductive anesthesia with Sevoflurane (BAXTER HEALTHCARE Corp, USA) was followed by placing a laryngeal mask. The delimiting retinal laser photocoagulation was performed using laser devices with an adapter on a binocular forehead ophthalmoscope Supra (Quantel Medical, France) and LachtaMylon (Lasermedservis, Russia,). After the surgery, the recovery from sedation and return of consciousness took 7 to 10 minutes. Results. An inhalation of Sevoflurane with the adoption of a laryngeal mask airway significantly decreases complications of anesthesia in premature infants with comorbidities and reduces the length of hospital stay. The quick clearance of Sevoflurane makes it possible to begin feeding the infant one hour after the surgery. Conclusion. Inhalation anesthesia with Sevoflurane is a method ensuring that preterm infants receive adequate anesthesia in the treatment of retinopathy of prematurity in its active phase.

Purpose: to analyze social media messages of patients with neovascular age-related macular degeneration (nAMD) and diabetic retinopathy (DR), or their careers in order to investigates the patients’ opinion in the condition of real clinical routine. Material and methods. Real-life anonymized stories of patients from Russian-language open Internet sources (forums, social networks in Russia) were processed by artificial intelligence techniques: the technologies of automated analysis of unstructured natural language texts, including semantic technologies. In these messages, patients and their careers (mainly, family members) openly and in an ‘uncensored’ way share their experience in diagnostics and treatment while looking for a second opinion or supporting each other. They use general social networks as well as specific disease-related forums or Q&A portals. We identified 73 098 DR/nAMD-related posts, including 13 138 posts by 844 DR patients and 358 posts by 212 nAMD patients. The posts were analyzed in several steps with the technologies of automated analysis of unstructured natural language texts including semantic technologies aimed at processing large volumes of data. The semantic analysis of texts dealt with the whole meaning rather than individual keywords. Results. We obtained information on the patients’ characteristics and treatment plans of retinal diseases in real practice but also on the patients’ attitude to their condition, diagnostic and curative procedures, their needs and difficulties experienced during treatment. The nAMD and DR patients have a low level of Internet activity and poor awareness of these diseases as compared with the patients suffering from non-ophthalmological diseases with lower prevalence (breast cancer, multiple sclerosis, etc.) or other ophthalmological disorders. Most of the content for DR was produced by the patients’ relatives (82.6 % of messages), and for nAMD — by the patients themselves (65 %). The key item for DR patients was diabetic microvascular manifestations (over 42 000 posts discussed ‘diabetic foot’ and only 681 ‘diabetic retinopathy’). Quality of life (QoL) was shown to be significantly affected with inability to work as a major burden for 30 % of nAMD patients, and diabetes-associated comorbidities as a key factor compromising QoL in 20 % of DR patients. In nAMD patients, the average time-to-diagnosis after disease manifestation was 1 year (35 % patients reported 1–2 months), in DR, over a half of the messages mentioned 1–2 years. The key reasons for visiting the clinics included in-depth eye exams (OCT mentioned by 59 % of nAMD patients) and treatment (24.1 %). Only 33.2 % of nAMD patients and 7 % of DR patients noted that they received anti-VEGFs. Treatment unaffordability is one of the key barriers. The patients lack clear understanding of the prognosis and effective treatment options. Conclusion. The study revealed low activity and awareness of nAMD and DR patients with regard to their diseases. This justifies the need of increasing computer literacy and awareness of effective treatment options and efficacy criteria not only in patients, but also in their younger relatives. The results confirm that, among the studied group of retinal patients, vision-related quality of life is compromised. We need to change at least several aspects of nAMD and DR patients’ management: reducing the time to diagnosis, prescribing effective treatment options and increasing the availability of these options.

Purpose: to evaluate the expediency and efficacy of conservative therapy of patients with inactive stages of Graves’ orbitopathy complicated by optical neuropathy. Materials and methods. 62 patients with an inactive stage of Graves’ orbitopathy complicated by optical neuropathy were divided into two groups: group 1 (21 patients, 33.9%) received only symptomatic and local therapy, while group 2 (41 patients, 66.1%) additionally received periorbital injections of glucocorticoid drugs. The patients were examined clinically and instrumentally before and after treatment as well as after a long period of more than 12 months. Results. A positive clinical effect of treatment confirmed by positive dynamics of functional indices of computer perimetry (MS, MD) was achieved in 44 cases (71%), of which 33 patients (75.0% ) belonged to group 2. Positive changes in group 1 were achieved in 52.4% of cases and in group 2 in 80.5% of patients. Long-term results showed stable positive changes in 92.1% of cases. Conclusion. The need for complex therapy, involving local injections of glucocorticoid drugs, of patients in an inactive stage of Grave’s orbitopathy who develop symptoms of optical neuropathy was substantiated.

Purpose: to evaluate the effectiveness of approaches to tear substitution in dry eye syndrome (DES) patients before cataract phacoemulsification (CPE). Material and methods. 60 DES and cataract patients who received preoperative therapy — tear substitute instillations (4 times a day, 1 month), were examined before CPE. They were divided into 2 groups each of which was subdivided into two subgroups. Group 1 included 30 mild DES patients with lipid deficiency who had a negative lipid interference test, meibomian gland dysfunction (MGD), and aqua deficiency absence (Schirmer-1 test > 15 mm). The subgroup 1.1 (15 patients) received 0.18 % sodium hyaluronate (SH) instillations (Gilan comfort), while the other subgroup 1.2 received “fat-water” type emulsion instillations. Group 2 consisted of 30 moderate DES patients with lipid-aqua deficiency, who also had negative lipid interference test, MGD, and aqua deficiency presence. Subgroup 2.1 (15 patients) received 0.3 % sodium hyaluronate (SH) instillations (Gilan ultra comfort), while subgroup 2.2 patients received “fat-water” type emulsion instillations. We evaluated: the OSDI points, and tear break-up time (TBUT). Results. As a result of therapy, a positive effect of the therapy on OSDI and TBUT was observed in all subgroups. In group 1 , OSDI decrease and TBUT increase were more pronounced in subgroup 1.1 patients, however, this difference between subgroups was not statistically significant. In group 2, OSDI decrease and TBUT increase were more pronounced and statistically significant in subgroup 2.1 patients. Conclusion. In patients with mild DES and lipid deficiency, 0.18 % SH (Gilan comfort) demonstrated a positive effect on OSDI and TBUT comparable to the “fat-water” type emulsion. In moderate DES patients with lipid-aqua deficiency, 0.3 % SH (Gilan ultra comfort) demonstrated a statistically significant and more pronounced positive effect on OSDI and TBUT than the “fat-water” type emulsion.

Purpose: to present the functional results of primary early vitrectomy in patients with subtotal and total hemophthalmos with penetrating wounds and severe contusions of the eye. Material and methods. 41 patients were observed, including 24 patients (24 eyes) with a penetrating eye injury and 17 patients (17 eyes) with a severe eye contusion. All patients had subtotal or total hemophthalmos. All patients underwent a 25G three-port vitrectomy no later than 3 days after the injury. 33 patients received a tamponade with silicone oil 5700, and 8 patients received gas-air mixture C3F8. The follow-up period was 6 months. Results. On the first day after surgery, 31 patients treated with silicone oil tamponade showed an improvement in visual acuity. With gas-air tamponade, visual acuity as light perception was obtained for 1 day; as the gas resorbed, objective vision appeared in all 8 cases. Six months after the surgery, a good anatomical result was achieved: no signs of subatrophy were detected in any of the presented patients. An unfavorable outcome (lacking or incorrect light perception) was observed in 4 cases (9.75%), a relatively favorable functional outcome in the form of objective vision less than 0.1, in 17 cases (41.5%), a favorable outcome with visual acuity above 0.15 in 20 cases (49%). Signs of proliferative vitreoretinopathy were noted in 8 patients (19.5%), which in cases of severe penetrating wounds and contusions and a number of complicating factors is a good result as compared to the available literature statistics. Conclusion. Our study shows that in patients with total and subtotal hemophthalmos with penetrating eye wounds and severe contusions, primary vitrectomy should be performed at an early stage. After the surgery the patients receive a statistically significant increase in visual acuity, have a stable anatomical result and, in the long term, obtain a good functional result.

Purpose: to assess the biophysical properties of the sclera by measuring its acoustic density in keratoconus, highly myopic, and healthy eyes. Material and methods. We examined 34 patients (67 eyes) aged 15–45 with keratoconus of various stages, 15 patients (30 eyes) aged 17–28 with high myopia and 15 people (30 eyes) aged 28–37 without ophthalmic pathology. The acoustic density of the sclera (ADS) was measured on the Voluson Е8 ultrasound device (GE Healthcare, USA) in the posterior eye pole (ADS-1) and in the equatorial area (ADS-2). The axial length (AL) of the eye, corneal thickness (CT), anterior chamber depth (ACD), and lens thickness (LT) were determined using Galilei G6 (Ziemer Group, Switzerland). The vitreal chamber depth (VCD) was calculated according to the formula: VCD = AL – СT – ACD – LT. Results. In keratoconus patients, the average ADS-1 value was 242.5 ± 7.4 conventional units (CU), ADS-2 averaged 234.1 ± 12.1 CU, AL was 24.6±1.1 mm long, and VCD was 17.1 ± 0.4 mm. In high myopia group, the average value proved to be significantly lower: ADS-1 was 210.3 ± 15.7 CU, ADS-2 — 201.2 ± 11,2 CU, while AL and VCD were higher: resp. 27.0 ± 0.7 mm and 19.2 ± 0.5 mm (p < 0,05). In the control group (healthy eyes), ADS-1 was 247.5 ± 2.8 and ADS-2 was 238.1 ± 0.6 CU, which practically showed no difference to the keratoconus group (p > 0.05). AL was 23.7 ± 0.6 mm, and VCD was 16.0 ± 0.6 mm. An insignificant tendency toward ADS drop in keratoconus eyes with AL over 25.0 mm was observed. Probably, we are dealing here with a combination of keratoconus with axial myopia. Conclusion. The acoustic density of the sclera of keratoconus patients approaches the respective parameter of healthy eyes and is significantly higher than that of highly myopic eyes. The analysis of acoustic density of the sclera and vitreal chamber depth may be considered as a method of additional differential diagnostics of keratoconus and congenital myopia with high corneal refraction and astigmatism.

Purpose: to evaluate the effectiveness of combined treatment of chronic central serous chorioretinopathy (CSCRP) complicated by type 1 choroidal neovascularization (CNV) by subthreshold micropulse laser exposure (SMILE) and intravitreal injection of angiogenesis inhibitors ( IIAI). Material and methods. 37 patients (20 men and 17 women) with monolateral chronic recurrent CSCRP complicated by type 1 CNV, aged 35 to 57 (ave. 43.6 ± 6.7 yrs.) at the moment of first referral, were divided into two groups. The retrospective group included 15 patients (15 eyes) whose first phase of treatment consisted in IIAI (up to 5 injections with an interval of one month). Those who showed no treatment effect were given a SMILE procedure one day before the 6th injection. If neurosensory retinal detachment persisted, the combined treatment (SMILE + IIAI) was repeated monthly until the neurosensory retina could be fully attached, whereupon the patients were transferred to monotherapy with anti-VEGF injections, gradually increasing the interval between the injections. The main group included 22 patients (22 eyes), whose treatment began with a single IIAI. If no neurosensory retinal detachment resorption occurred, the patients received a SMILE procedure one day before the second IIAI injection. The combined treatment was repeated monthly until neurosensory retinal detachment completely resorbed, then the treatment continued with IIAI alone with a gradual increase of intervals between the injections. Results. The number of IIAI in the main group (5 to 8, ave. 6.1 ± 0.8) was significantly lower than in the retrospective group (8 to 10, ave. 8.8 ± 0.77). Best corrected visual acuity increased in both groups, but the main group showed a better central photosensitivity, which is associated with the faster reattachment of neurosensory retina. By the end of the follow-up period, the area of type 1 CNV, and the thickness of the choroid were significantly lower in the main group as compared to the retrospective group. The combined treatment did not cause a single case of complication. Conclusion. The proposed combination of laser exposure followed by IIAI is a safe method for treating complicated forms of CSCRP, which quickens the resorption of subretinal fluid and reduces the number of treatment procedures.

Purpose. To evaluate the change in the functional activity of retinal ganglion cells (RGCs) in response to intraocular pressure (IOP) drop in patients with newly diagnosed early stage primary open-angle glaucoma (POAG) using a pattern electroretinogram (PERG). Material and methods. A prospective non-randomized cohort study included 12 patients (24 eyes) including 5 men, 7 women, aged 63.42 ± 2.96 years with newly diagnosed early stage POAG in at least one eye, who underwent PERG (Diopsys Nova, Diopsys, Inc.) in addition to an ophthalmologic examination. After being diagnosed with POAG, all patients were prescribed prostaglandin analogues as monotherapy. One and four months into the treatment, repeated examinations took place. Results. At these time points, a significant decrease in IOP was noted, accompanied by an increase in PERG parameters , which indicates an improvement in the functional activity of RGCs, yet no linear relationship between the IOP decrease and the improvement in PERG parameters could be found. Conclusion. Early stage naïve-treatment POAG patients with minimally impaired visual fields as determined by threshold computer perimetry may have their RGCs functional activity partially restored and IOP lessened thanks to continuous IOP-lowering therapy with prostaglandin analogues. PERG can be used as a method for evaluating the effectiveness of glaucoma hypotensive therapy in terms of maintaining and improving the functional activity of RGCs.

Purpose: to evaluate the effectiveness of surgical treatment of the floppy eyelid syndrome. Material and methods. The clinical group consisted of 23 patients (46 eyes) with the floppy eyelid syndrome (16 men and 4 women), ave. aged 46,0 ± 2.6 years. Of these 20 patients underwent surgery for floppy eyelid syndrome by vertical and horizontal shortening of the upper eyelid with or without correction of blepharoptosis. The observation period ranged from 1 month to 10 years. Fragments resected during the operation were subjected to histological examination. Results. A histological study revealed a reduced quantity or absence of elastin in the tarsal plate, destruction of collagen fiber beams, malformation of hair follicles accompanied by moderate chronic inflammation, In the postoperative period, the complaints caused by involuntary ectropion of the upper eyelid disappeared in all patients, the palpebral fissures became maximally symmetric. Conclusion. Surgeries performed by our technologies result in the best possible anatomical arrangement of the upper eyelid within a single-stage procedure.

Purpose. To assess the clinical efficacy of the SRK II formula with a correction factor Rm in children with congenital cataracts who are at risk of pseudophakic myopia. Material and methods. A complex examination of 48 children (86 eyes) with congenital cataracts involved visometrics, tonometry, tonography, biomicroscopy, keratorefractometry, ophthalmoscopy, ultrasonography, and pachymetry. To determine the IOL power, we used the SRK II formula supplemented with the individual correction factor Rm, proposed by the authors. The examined children were divided into 2 groups. The main group 1 included 22 patients (42 eyes), for which the IOL power was calculated with the Rm factor. The control group 2 consisted of 26 patients (44 eyes) for which the IOL power was calculated according to the traditional SRK II formula using age-related hypocorrection of refraction but without the Rm coefficient. Results. The correction factor Rm, allowed us to achieve the targeted refraction in children who were at risk of developing pseudophakic myopia in 83.3 % of cases of the main group (versus 45.4 % of the control group cases) and reduce the development of high age-related refraction) by 37.9 %. In children of the main group, visual acuity reached, on average, 0.5 ± 0.001, while in the control group it was also higher but only reached 0.200 ± 0.001. Conclusion. The method of calculating the IOL optical power involving an individual correction factor Rm, according to the formula: SRK II – R – Rm can be recommended for clinical practice focused on children at risk of abnormal refractogenesis.

Purpose. To investigate the influence of the axial length of eyes on the average macular thickness and to develop a method for assessing this optical coherence tomography (OCT) parameter in patients with refractive errors. Material and methods. The study involved 132 patients (132 eyes) over 40; of these, 43 patients with hyperopia (axial length 20–22 mm), 38 patients with myopia (axial length 25–28 mm) and 51 healthy subjects with emmetropia with similar gender and age distribution (axial length 22.5–24.5 mm). OCT was performed on a Cirrus HD-OCT device (Carl Zeiss Meditec, USA). Results. The average macular thickness in the emmetropia group was 282.4 ± 10.2 (261–304) μm. In patients with myopia, it was on average 7 μm less (274.9 ± 10.5; from 250 to 296 μm, p = 0.005), and in patients with hyperopia it was almost 6 μm thicker (288.2 ± 12.5; from 258 to 313 μm, p = 0.032). In the emmetropia group, normative data for the average macular thickness were determined. For eyes with the axial length of 20–22 and 25–28 mm, corrections for calculating the average macular thickness in emmetropic eyes have been developed, allowing comparison with the normative data. Conclusion. The average macular thickness decreases with the increase of the axial length of the eye. An original technique for assessing the average macular thickness in patients with refractive errors, adapted to the Cirrus HD-OCT device, was developed. For this device, the normative database of healthy subjects with emmetropia aged of 41–80 years has been compiled.

Adenoviral conjunctivitis (AVC) is treated with pathogenetically determined immunotropic drugs, the most commonly used of which are combined eye drops that include recombinant human interferon alpha-2b and diphenhydramine hydrochloride. In 2020, Russia registered the first domestic generic of the original, called Interferon-Ophthalmo eye drops. Purpose: to compare the effectiveness and safety of InterferonOphthalmo and the original interferon alpha-2b + diphenhydramine drug (Ophthalmoferon) in AVC patients. Material and methods. The study included 30 patients (60 eyes) aged 18–75 years with a clinically confirmed AVC, divided into the main group and the control group, each having 15 patients. The main group received Interferon-Ophthalmo, while the control group received Ophthamoferon. The treatment procedures were identical, with the follow-up period of 15 days. Clinical manifestations of AVC were assessed according to multiple parameters: complaints of eyelid edema, eye redness, lacrimation, itching, foreign body sensation, severity of conjunctival edema and hyperemia, follicular reaction in the lower conjunctival fornix, and hemorrhages. Results. The comparative assessment of the proportion of cases of clinical recovery, performed on the 7th and the 15th days of AVC therapy, confirms the same effectiveness of the two drugs. Conclusion. Interferon-Ophthalmo has a high clinical efficacy comparable with that of the original drug Interferon alpha-2b + Diphenhydramine and can be recommended for the treatment of patients with adenoviral ophthalmic infections.

Purpose: to determine the main characteristics of the mydriatic effect of drug formulations of phenylephrine, containing and not containing hypromellose, hyaluronic acid as an auxiliary component, in a comparative in vivo study, as well as to study their local bioavailability and the effect on the mucous membrane of the eye. Materials and methods. The studies were carried out on 40 adult male Soviet Chinchilla rabbits. The research model involved the mydriatic impact and the local irritant effect of the drug when instilled into the awake rabbit’s conjunctival sac. The peak concentration of phenylephrine, which is part of all formulations studied, was determined in the aqueous humor of the anterior chamber of the animal's eye at the 5-minute point by high-performance liquid chromatography with tandem mass spectrometric detection. Results. A single instillation of 1 drop of a 2.5% solution of phenylephrine hydrochloride containing hypromellose as an excipient is superior in depth, rate of reaching the maximum mydriatic effect and its duration to the formulation that does not contain hypromellose as an excipient. Only in a few cases, drug formulations containing hypromellose caused an insignificant weak reaction of eyelid closure, in contrast to a moderate local irritant reaction of the rabbit's eye occurring when phenylephrine solution without hypromellose is instilled. Peak concentrations of phenylephrine in the aqueous humor of the anterior chamber of the eye determined 5 minutes after instillation of 1 drop of 2.5% phenylephrine solutions containing hypromellose significantly exceed those occurring when phenylephrine drugs of the same concentration that do not contain hypromellose are instilled. Conclusion. The inclusion of hypromellose as an auxiliary substance into the formulation of phenylephrine eye drops optimizes the pharmacodynamics and pharmacokinetics of the active substance due to faster penetration into the eye anterior chamber aqueous humor, increasing local bioavailability and prolonging the exposure time. In addition, the absence of a local irritating effect of such forms on the eye tissues may also be explained by the presence of hypromellose.

Purpose: to analyze the levels of cytokines in intraocular fluid (IF) and blood plasma of patients with diabetic macular edema (DME) previously untreated by intravitreal therapy before and after the therapy by angiogenesis inhibitor or a corticosteroid. Material and methods. We examined 90 people — 47 females (52.2 %) and 43 males (47.8 %), mean age 64.54 ± 11.30 years. Of these, 60 had DME, and 30 formed the control group. The levels of 41 cytokines/chemokines in IF were determined by Milliplex® Map Human Cytokine/ Chemokine Panel; while the concentration of IL-18, MCP-1/CCL2, EPO, IL-10, IL-4, IL-6, IL-8, IFNα, VEGF-A in blood plasma was measured by enzyme-linked immunosorbent assay kits (Vector-Best, Russia). Patients with DME received intravitreal injections of an angiogenesis inhibitor (aflibercept. 50 eyes) or a corticosteroid (dexamethasone implant, 30 eyes). Results. Significant differences were revealed in 10 cytokine concentrations between the DME patients and the control group. The concentrations of IL-7, IL-15 and MCP-1/CCL2 levels in IF of DME patients were, respectively, 20.5, 20.3, and 11.02 times higher, than in the control group (р ˂ 0.05). Besides, a pairwise comparison of cytokines concentrations in IF of patients from either treatment group with the controls demonstrated a statistically significant increase in GROα/CXCL1 level. The pairwise comparison also revealed significant differences between the control and the corticosteroid therapy for systemic concentrations of IL-18 (p = 0.017), MCP-1/CCL2 (p = 0.009) and VEGF-A (p = 0.016). Conclusion. A pronounced and significant increase of the levels of a number of cytokines (e.g., IL-7, IL-15. FRACTALKINE/CX3CL1) were only sparsely reported before or remained undetermined at all. Our results on systemic cytokines levels may serve as prerequisite for further research into the role of systemic inflammation in DME pathogenesis. The analysis of associations of our results with those of other clinical biomarkers will contribute to the development of individualized treatment strategies.

The number of ophthalmic antihypertensive drugs available in Russia is steadily increasing, which complicates the choice to be made by ophthalmologist practitioners. Purpose: to compare the efficacy and safety of the domestically produced drug Latanoprost-Optic with the original drug Xalatan used as monotherapy or combined with the domestic drug Dorzolamide-Optic in patients with primary open-angle glaucoma (POAG). Material and methods. 116 completed cases of patients aged 69.3 ± 5.7 with newly diagnosed POAG were retrospectively analyzed, whereby we assessed the efficacy, safety and tolerability of monotherapy with Latanoprost-Optic or Xalatan and their combinations with Dorzolamide-Optic. Results. Latanoprost-Optic efficacy is no worse than that of Xalatan as it reduces intraocular pressure (IOP) by 33.8%, and has a comparable safety and tolerability profile. More than 72% of patients rate the tolerability of treatment with LatanoprostOptic as very good or good. An additional hypotensive effect of Dorzolamide-Optic added to latanoprost is 2.6–2.8 mm Hg, or 13.2–14.4% and involves no significant effect on the safety profile and tolerability of therapy. Conclusion. Latanoprost-Optic can be considered as a more affordable alternative to the original drug. If the target IOP values cannot be achieved by latanoprost alone, its combination with DorzolamideOptic is recommended, especially for patients with chronic diseases of the respiratory system and the cardiovascular system.

Meibomitis (M) is an inflammation of the meibomian gland (MG) with the involvement of the surrounding tissue. One of the causes of M is an obstructed outflow of fat secretion, complicated by an accompanying infection. The authors propose a new algorithm for the treatment of M (complex conservative therapy, probing of the meibomian gland with an eyelash, and dissection) and offer a classification of meibomitis, which provides a better understanding of the various forms and stages of the disease. Practical application of the proposed treatment algorithm and the classification of M are illustrated by four clinical cases, which reveal the possible causes of M, unusual forms of its manifestation, and open new possibilities of eyelash probing of the meibomian gland.

The literature review presents the results of optical coherence tomography and optical coherence tomography — angiography used for Graves’ orbitopathy. The data on the thickness of the inner layers of the retina, microcirculation in the peripapillary and macular regions, parameters of the choroid, lamina cribrosa and extraocular muscles were analyzed as possible diagnostic criteria of the condition.

The literature review discusses the impact of scheduled hemodialysis on the state of the anterior part of the eye, the chorioretinal complex, the central and peripheral vision. The hemodialysis procedure is accompanied by a decrease in basal tear production, quickening of the tear film break-up, and an abnormal ocular surface disease index. Thinning of the corneal center is not accompanied by significant keratometric changes. Intradialytic thinning of the choroid and reduction of ocular perfusion pressure may be involved in the progression of ischemic eye diseases. Lower visual acuity is associated with the instability of the lens and choroid thickness. The impact of hemodialysis on the peripheral vision has not been sufficiently investigated. The correlations of ophthalmic changes with systemic effects of the dialysis are ambiguous. The inconsistency of the research results requires that the research should be continued.

Posterior eye segment involvement in COVID-19 has varied manifestations: vascular, inflammatory, and neuronal. All of them are triggered by SARS-CoV-2 virus but they cannot be viewed as exclusively specific to COVID-19. According to the literature, the mean age of the patients varies from 17 to 75 with the median of 50 years. The median duration between the appearance of ophthalmic symptoms and the detection of COVID-19 was 12 days. The disease affects both men and women equally. Direct exposure to the virus, immune-mediated tissue damage, activation of the coagulation system, the prothrombotic state caused by a viral infection, concomitant diseases and medications used in the treatment contribute to the development of eye pathologies. Ophthalmologists should be aware of the possible relations of posterior eye segment pathologies, orbit and neuro-ophthalmic disorders with SARS-CoV-2, as well as the possible exacerbation of chronic forms of inflammatory eye diseases and autoimmune disorders due to anti-COVID-19 vaccination.

The visualization of the surgical process remains a topical issue in cataract surgery. The review presents the history of visualization technique in ophthalmic surgery and compares the main current analogue and 3D digital technologies. The advent of 3D imaging systems in clinical practice has helped solve many issues associated with the use of standard analogue microscopes. These issues include limited focus and field of vision, the need to use a large amount of light, which increases the risk of iatrogenic retinal phototoxicity, the surgeon's attachment to the microscope and, consequently, a high load on the surgeon's visual apparatus when using eyepieces, as well as on their back and neck muscles.