Purpose: to study the prevalence and manifestation features of myopia in students of educational schools in the city of Orenburg.

Material and methods. 710 schoolchildren of Orenburg schools, aged 11 to 18, were examined.

Results. Myopia was found to be the most common pathology of the eye, diagnosed in 33.5 % of schoolchildren. The most frequent was low myopia claiming 65.4 % of myopic cases, followed by moderate myopia (28.5 %) and high myopia (6.1 %). The highest occurrence of myopia was revealed in 11th and 8th grade students (respectively, 55.8 and 40,0 cases per 100 examined subjects). It was found out that the share of more severe myopia stages (moderate and high) in increasing in older age groups 5th-grade to 11th-grade students. We also showed that myopia prevalence is connected with head and spine injuries in the case history.

Conclusion. Educational facilities need to introduce an effective system of myopia prevention and means of progression reduction.

Purpose: to compare the results of neovascular glaucoma (NVG) surgery of patients treated for the underlying eye disease with antiVEGF therapy and laser coagulation (LC) of the retina with the surgery results of patients who did not receive underlying disease treatment.

Materials and methods. A retrospective analysis of case histories and outpatient charts of 70 patients (70 eyes) with NVG, operated in a surgical hospital, involved two groups of patients: group 1 — 33 eyes of patients treated for the underlying disease with anti-VEGF therapy and/or LC; of these, 13 eyes (39 %) received panretinal LC, 15 eyes (45 %) received an anti-VEGF drug intravitreally, and 5 eyes (16 %) received both anti-VEGF therapy and LC); group 2 — 37 eyes of patients not treated for the underlying disease. In group 1, NVG was caused by diabetic retinopathy (DR), which accounted for 19 eyes (57.6 %), and post-thrombotic retinopathy (PR) — 14 eyes (42.3 %). IOP data in group 1 at admission was 38.00 ± 6.82 mm Hg. In group 2, the proportion of patients with DR was 32 % (12 eyes), and those with PR — 41 % (15 eyes). The level of IOP in group 1 upon hospital admission was 38.00 ± 6.82 mm Hg, while in group 2 it was 35.97 ± 5.85 mm Hg.

Results. In group 1, in most cases, the classical surgical approach to NVG treatment was used. The proportion of Ahmed drainage implantations was 46 % (15 eyes), trabeculectomy (TET) — 24 % (8 eyes), non-penetrating sinustrabeculectomy (NST) — 6 % (2 eyes), and only 24 % (8 eyes) received transscleral cyclophotocoagulation (CPC). After 7 days, the average level of IOP in group 1 was 16.80 ± 7.18 mm Hg, after 1 month, 19.50 ± 3.45 mm Hg, after 3 months, 21.80 ± 3.15 mm Hg, and after 6 months — 22.57 ± 3.34 mm Hg (p < 0.05). In group 2, the operation of choice was CFC, which was performed in 46 % (17 eyes), the Ahmed drainage was implanted less often — 36 % (13 eyes), while 18 % (7 eyes) accounted for TET. The IOP level in group 2 after 7 days was 20.00 ± 8.74 mm Hg, after 1 month, 25.30 ± 4.67 mm Hg, after 3 months 28.43 ± 6.54 mm Hg, and after 6 months 29.73 ± 4.18 mm Hg (p < 0.05).

Conclusion. The timely treatment of the underlying disease with Anti-VEGF and LC of the retina allows the patient to maintain visual functions, and increases the effectiveness of NVG surgery.

Purpose: to analyze the activity of α2-macroglobulin (α2-MG) in the tear, blood serum (BS), and aqueous humour (AH) in children with uveitis, and to assess the possibility of using α2-MG for inflammation activity estimation and prognosis.

Material and methods. 76 children with uveitis (135 eyes) aged 3 to 17 (ave. 10.45 ± 3.34 years), were tested for the activity of α2-MG (300 tear samples, 154 BS samples, 39 AH samples). The dynamics of α2-MG was assessed in the tear of 56 patients, and in BS of 53 patients. α2-MG activity was determined by the enzymatic method using the specific substrate N-benzoyl-DL-arginine-p-nitroanilide (BAPNA). The optical density was measured using a multifunctional photometer for Synergy MX microplates (BioTek, USA).

Results. No correlation was found between the α2-MG activity and the inflammation activity and localization of uveitis. In contrast, a significant decrease in α2-MG activity was found in the tear after anti-inflammatory therapy (p = 0.013). Also, a significant preoperative α2-MG increase was noted in the tear of children who experienced fibrin effusion into the anterior chamber of the eye in the early postoperative period (p = 0.022) It was shown that α2-MG activity in BS drops significantly as the patients grow up (p = 0.025). As the degree of proliferation increases, the activity of α2-MG in AH also increases (p = 0.049).

Conclusion. An increase of α2-MG activity in the tears in the preoperative period may be important for the prognosis of fibrin formation in the anterior chamber during the postoperative period. α2-MG in the tear is highly sensitive to anti-inflammatory drugs, which reduce its activity. In BS the highest activity of α2-MG was revealed at the age of 3–6 years, whereupon it is decreasing. In AH, the activity of α2-MG correlates with the stage of the proliferative process.

Purpose: to evaluate the impact of Optinol treatment on the ocular surface state in medical students with various types of ametropia.

Material and methods. The study involved 3 groups of patients: two clinical groups and a control group. The first clinical group consisted of 34 students (68 eyes) with mild, moderate or high hyperopia, averagely aged 20.1 ± 0.5 years. The second clinical group consisted of 47 students (94 eyes) with mild, moderate or high myopia, average aged 20.6 ± 0.9 years. The control group was composed of 60 students (120 eyes), averagely aged 21.4 ± 1.2 years, with no ophthalmic pathologies. Each group received Optinol consecutively in three different formulations: Optinol® Gentle Repair: dexpanthenol 2 % and sodium hyaluronate 0.15 %, Optinol® Deep Hydration: sodium hyaluronate 0.4 %, Optinol® Express Moisturizer: sodium hyaluronate 0.21 %. The case histories of the patients and typical complaints were revealed by the questionnaire method. The state of the eyelids and the conjunctiva was assessed by biomicroscopy. To diagnose the dry eye syndrome (DES), special tests were used: LIPKOF, Schirmer and Norn tests.

Results. Despite the higher LIPKOF scores in the 1st (hyperopic) group, showing stage III as compared to the 2nd (myopic) group where it scored stage I, the Norn test score showed a stronger reduction in the 2nd group. The LIPKOF test improved in the hyperopic group, falling to 1.23 ± 0.10 mm (stage I), which corresponded to one conjunctival fold. The index of tear film stability (Norn's test) increased in group 1 by 3.1 ± 0.1 sec, and in group 2 by 2.2 ± 0.2 sec.

Conclusion. DES was found to be more frequent in hyperopic students. Optinol is a pathogenetically oriented drug, targeting tear production disorders and ocular surface changes. The drug demonstrates high efficacy, good tolerability and safety profile, so that it could be recommended for managing multiple types of ametropia.

Purpose: to summarize the experience of the development and application of artificial neural networks (ANW) in early diagnosis of primary open-angle glaucoma (POAG).

Material and methods. A total of 690 patients (918 eyes) were tested. The training clinical group consisted of 459 clinical examples (459 eyes), of which 369 eyes had an initial stage of POAG and 90 eyes had no glaucoma. The testing clinical group was represented by 131 examples (131 eyes), of which 110 eyes belonged to patients with POAG and 21 eyes were without glaucoma. The final diagnostic testing using ANW was conducted on 328 eyes with the diagnosis unknown to the researchers, which belonged to people with suspected POAG. The diagnostic complex included an optimally necessary set of research techniques.

Results. ANW identified glaucoma in 198 eyes out of those with suspected glaucoma (60.4 %) with 100 % certainty. 76 eyes (23.2 %) were classified as non-glaucoma, or “healthy”; 54 eyes of the suspected glaucoma patients were identified as “doubtful”, whereupon they were retested by a neural network pool consisting of 5 neural networks. According to the results of the retesting, 28 eyes, or 51.9 % of the “doubtful” ones were identified as having glaucoma, whereas 26 eyes (48.1 %) were identified as non-glaucomatous, i. e. healthy.

Conclusion. Our experience suggests that artificial neural networks pose no danger to the doctor or the patient and can be viewed as a very convenient tool for early POAG diagnostics.

The improvement in nursing routine of premature babies with low and extremely low body weight has increased their survival rate. Along with the growing number of such children, retinopathy of prematurity (ROP) occurs relatively less often and its outcome becomes more favorable. Modern approaches to the surgical treatment have led to a significant reduction in the incidence of blindness and visual disability caused by ROP. Yet, ROP remains one of the major issues in neonatal ophthalmology, often associated with refractive disorders.

Purpose: to evaluate the refractive changes in children with ROP after transpupillary laser coagulation of the retina based by clinical experience.

Materials and methods. We analyzed 5 clinical cases of children with ROP treated in Children's City Clinical Hospital No 1 during the period from 2013 to 2014. All patients underwent retinal transpupillary laser coagulation; its volume determined by the stage of ROP. Eye refraction data were noted at the age of 1 and 7 years. The quality of visual functions and the axial length of the eye were determined at the age of 7.

Results. All patients had hyperopia of varying degrees at 1 years old. By the age of 7, one patient developed myopia, another one had emmetropia, while the rest of children had hyperopia of varying degrees. Regardless of the refractive error type, the axial length of the eye remained significantly below the age norm. The low quality of visual functions is due to the lack of full-time optical correction and irregular outpatient observation.

Conclusions. Most often, hyperopia refraction in children with ROP is accompanied by a short axial length of the eye. Full-time optical correction should be prescribed, and spectacle wearing should be monitored by parents and ophthalmologists who observe the patients.

Purpose: to determine objective echographic criteria for the differential diagnosis of anterior ischemic optic neuropathy (AION) and optic neuritis (ON).

Material and methods. The research involved 60 patients aged 40 to 60 years, including 30 patients with suspected AION and 30 patients with suspected ON. The control group consisted of 40 healthy volunteers. In addition to the standard ophthalmological examination, all patients underwent ultrasound optic nerve s examination with measurement of the optic nerve thickness and acoustic density (AD) of the parenchyma and optic nerve sheets. Assessment of blood flow in retrobulbar vessels was carried out in the modes of Color Doppler Imaging and pulse dopplerography.

Results. There were no statistically significant differences in average echographic parameters of the optic nerve s thickness between the groups of patients with AION and ON. In patients with ON there was a statistically significant decrease in the average AD index compared to that in patients with AION and in healthy volunteers (106.02 ± 5.40 y. e., 146.58 ± 9.70 y.e. and 135.3 ± 2.1 y. e., accordingly). The AD values in all patients with AION exceeded 133 y. e., in patients with ON this index was less than 132 y. e. Evaluation of hemodynamic parameters in the vessels of the eye demonstrated a statistically significant decrease in the peak systolic velocity (Vsyst) and end-diastolic velocity (Vdiast) blood flow in the central retinal artery and medial and lateral short posterior ciliary arteries in patients with AION (in 2-fold) compared with ON and normal indices (p < 0.001). There were no statistically significant differences between parameters of blood flow in patients with ON and in healthy volunteers. In addition, there were no significant intergroup differences of hemodynamic parameters of the ophthalmic artery (p > 0.05).

Conclusions. AD of the optic nerve and parameters of blood flow velocities (Vsyst and Vdiast) in medial and lateral short posterior ciliary arteries can be attributed to the diagnostic criteria of the AION and ON.

Purpose: to compare anatomical and optical parameters and aberrations of both eyes in patients with acquired and congenital anisometropic myopia.

Material and methods. 22 patients (44 eyes) aged 18–35 (averagely, 25.2) with acquired and congenital anisometropic myopia were examined using the Galilei G6 optical eye system analyzer (Ziemer, Switzerland). The analysis of total, corneal and internal aberrations of the eye was carried out on an OPD-Scan III (Nidek) aberrometer.

Results. In both groups with acquired and congenital anisometropic myopia, the axial length of the higher myopic eye was greater than that of the fellow eye. A greater asphericity and higher astigmatism of the cornea were revealed in higher myopic eyes of patients with congenital myopia as compared to acquired myopia. The total RMS HOA in congenital myopia was significantly greater in the higher myopic eye compared to the fellow eye (1.07 D and 0.68 D, respectively) and greater than in cases of acquired myopia. All HOA were greater in higher myopic eyes as compared to the fellow ones in cases of congenital myopia. In case of acquired myopia only the total coma appeared to be greater in the higher myopic eye. Corneal aberrations in acquired anisometropic myopia did not differ in the paired eyes. In case of congenital myopia, the total tilt was significantly greater in the higher myopic eye, and total coma and spherical aberration have lower values, even with a transition to negative ones (p < 0.05).

Conclusion. The revealed differences of the wavefront of the eyes with anisometropic congenital and acquired myopia are rather a consequence of anatomical and optical differences (the axial length of the eyes and the topography of the cornea), than the cause of anisometropia.

Disorders of ocular perfusion are associated with huge amout of diseases, including such socially significant as diabetic retinopathy and glaucoma. To date, there is no gold standard for measuring ocular perfusion. An innovative method for two-dimensional assessment of eye blood flow — laser speckle flowgraphy (LSFG) — has been developed recent years and implemented in ophthalmological practice.

Purpose: to evaluate the possibilities of LSFG for determining ocular blood flow and to find out the age dependence of the obtained indicators of ocular blood flow.

Materials and methods. The study includes 60 healthy volunteers. The examined persons were divided into 3 groups of 20 people depending on their age — 20–40 years old, 41–60 years old, and over 61 years old. All examined persons had high visual acuity and normal blood pressure. The study was carried out on an LSFG-RetFlow device (Nidek). The shape of the pulse wave, its qualitative and quantitative characteristics including the main parameter of LSFG - MBR (Mean Blur Rate) were determined.

Results. A significant decrease with age of most studied parameters of blood flow volume was revealed, the changes were significant (p £ 0.05). The highest MBR parameters were noted in the group of 20–40 years old. In the macular area, MBR values decreased more significantly in the group after 60 years age, while for the optic nerve head (ONH), a decrease has been already noted after 40 years age. In average, the decrease was 25–34 % for the ONH area and 33–38 % for the macular area. Changes of the other parameters of the pulse waveform had a similar trend.

Conclusion. LSFG is a reliable method for quantifying ocular blood flow. Our data support that LSFG-derived MBR and pulse wave measurements may be useful biomarkers for ocular perfusion changes. The identified age-related blood flow changes should be taken into account during the analysis of patients data.

Purpose: to determine the role of the systemic angiotensin II (AT-II) in the pathogenesis of retinopathy of prematurity (ROP) and assess its prognostic value.

Material and methods. 34 premature infants at risk of developing ROP were examined according to the ophthalmological ROP screening protocol adopted in the Russian Federation. Retrospectively, the infants were divided into 2 groups: those without ROP (n = 15) and those with developed ROP (n = 19). The average gestational age of those without ROP was 28.12 ± 0.64 weeks, their average body weight at birth was 1164 ± 118.6 g. The respective values for the group with ROP were 27.8 ± 0.6 weeks and 1142.6 ± 108.4 g. The two groups had similar extent of general somatic burden. At 32–35 weeks and 36–39 weeks of post-conceptual age (PCA), the infants of both groups were tested for the concentration of AT-II in blood serum using the enzyme-linked immunosorbent assay (ELISA).

Results: on the 32–35 week of PCA, the average level of AT-II in blood serum of premature infants of the ROP group was significantly increased as compared to that of the non-ROP group (p = 0.03), while on the 36–39 week of PCA no statistically significant difference between the AT-II levels in the examined groups was found (p = 0.73).

Conclusion. We established that the systemic AT-II level has a trigger role in the development of ROP. A high level of this parameter found at the onset of ROP can be considered as an early prognostic criterion for the risk of ROP development.

Purpose: a comparative study of the efficacy and safety of the combination drug Brinzopt Plus and the original drug Azarga used as adjunctive therapy in patients with primary open-angle glaucoma (POAG) previously treated with latanoprost.

Material and methods. 30 patients (42 eyes) with advanced and far advanced POAG were randomly divided into 2 groups of equal size. The patients of the main group (21 eyes) received Brinzopt Plus, those of the control group had the original drug Azarga, one instillation 2 times a day. The target points were intraocular pressure (IOP), visual acuity, perimetric indices (MD, PSD), mean retinal nerve fiber layer thickness, minimal neuroretinal rim width, retinal nerve fiber layer thickness in the macula, ganglion cell layer thickness in the macula, inner plexiform layer thickness, as well as the number of adverse events. The observation period was 12 weeks. IOP was measured at 4 and 12 weeks.

Results. After 2 weeks, both groups showed a statistically significant decrease in IOP, which remained stable after 4 and 12 weeks. The average decrease in IOP in Brinzopt Plus recipients was 25% and revealed no statistically significant differences with the original drug at any control point. A positive dynamic of visual acuity, static perimetry and optical coherence tomography values, which showed no significant intergroup differences, was recorded. Among the adverse events, manifestations of mild local discomfort were recorded in 4 out of 15 patients of the main group and in 3 out of 15 patients of the control group. No serious or systemic adverse events were noted.

Conclusion. Brinzopt Plus has an efficacy comparable to the original drug and a favorable safety profile.

Purpose: to develop new approaches to Morgagnian cataract surgery by optimizing the phacoemulsification technique and reducing the risk of surgical complications.

Material and methods. 22 patients (22 eyes) with hypermature Morgagnian cataract were divided into 2 groups. The main group I included 11 patients who underwent surgery according to the PEC technology using iridocapsular retractors, an intracapsular ring and the scaffold technique with the last nucleus fragment relocated into the anterior chamber. The comparison group II included 11 patients with PEC and IOL implantation using iridocapsular retractors and an intracapsular ring with no scaffold technique involved. In 7 patients of group I, the lens nucleus was considered “large” and in 4 patients, “small”. In 8 patients of group II, the lens nucleus was considered “large” and in 3 patients, “small”.

Results. After 6 months, BCVA in group I was 0.60, whilst in group II it was 0.70. IOP in group I averaged 12.9 mm Hg, while in group II it averaged 17.90 mm Hg. The endothelial cell density (CD) in group I decreased by 241 cells and amounted to 2012.0 cells/mm2 , the endothelial cell loss was 10.70%, while in group II CD loss was greater. It dropped by 377 cells (15.60%) and amounted to 2039 cells/mm2 .

Conclusions. The severity of involutional changes in the ligamentous apparatus of the lens in Morgagnian cataract was found to depend on the nucleus size. A working classification of Morganian cataract by the nucleus size has been proposed. The use of scaffold technique with the relocation of the last fragment into the anterior chamber made it possible to reduce the share of surgical complications to 18.18%. During phacoemulsification of Morgagnian cataract with small nuclei, surgical complications took place in both group I and II, which necessitates further improvement of the existing surgical technique of this type of pathology.

Purpose: to assess the effectiveness of the combined interferon alpha-2b-based medicine (Ophtalmoferon, eye drops) in the complex treatment of herpetic keratitis in patients who had coronavirus infection caused by SARS-CoV-2.

Materials and methods. The study group included 53 people aged 18 to 74 years (mean age 46.0 ± 7.8 years) with the following complaints: decreased vision, redness, eye pain, lacrimation, photophobia and foreign body sensation under the eyelid. Criteria for selection and inclusion of patients were: typical for herpetic keratitis corneal infiltrates detected by biomicroscopy; herpetic infection detected by Polymerase Chain Reaction (PCR) in the affected eye corneal scrape; a medical history of the novel coronavirus infection confirmed by PCR. The patients were divided into two groups. Group 1 (n = 32) received complex treatment with the combined interferon alpha-2b-based medicine (Ophtalmoferon®, eye drops) at early stages of the disease (from the 1st to 7th day after the first complaints). Group 2 (n = 21) received complex treatment with Ophtalmoferon® at later stages (from the 14th day of the first complaints). The effectiveness and tolerability of Ophtalmoferon were assessed during the dynamic monitoring of the patients.

Results. A positive trend was noted in 79.2 % (n = 42) of all patients who received Ophtalmoferon for the complex treatment of herpetic keratitis: a gradual improvement in visual acuity, reduction or disappearance of photophobia, lacrimation and eye pain. In 20.8 % (n = 11) of all cases, mostly related to the late start of etiological therapy, the treatment effectiveness was lower, the disease lasted longer and was accompanied by the involvement of the choroid, the development of more severe opacities in the place of corneal infiltrates. Due to later start of etiotropic therapy the inflammatory process affected deeper layers of the cornea up to the development of corneal ulcer with perforation, which required surgical intervention.

Conclusion. The etiotropic treatment of herpetic keratitis in patients after COVID-19, if started in the first days of the disease, can quickly stop the inflammatory process and prevent its spread to deeper layers of the cornea. Ophtalmoferon is a highly effective medicine for etiotropic treatment of keratitis caused by herpesviruses. Due to high patient compliance, Ophtalmoferon can be recommended for wide use in the complex therapy of herpetic keratitis.

Purpose: evaluation of the remote functional and refractive results of mixed astigmatism correction in preschool children with “plus” cylinders in the framework of a long-time longitudinal study.

Material and methods. 38 children (75 eyes) aged 1.5–7 years (averagely 4.2 years) with mixed astigmatism of 0.75 to 4.25 D (averagely 1.85 D) were followed up for 6-15 (averagely 7.3) years. At the first examination, all children were prescribed to permanently wear (+) cylinders of 0.5 D to 3.5 D. Over the follow-up period, (+) Cyl could be weakened in 24 eyes (32 %) due to a decrease in astigmatism, while (-) Sph had to be added in 24 eyes (32 %). due to an increased refraction. In cases when the full correction using a “plus” cylinder left an excessively large myopic defocus, the power of the “plus” cylinder was reduced so as not to add a “minus” sphere, and a second pair of glasses was prescribed for near vision, which offered a full correction of astigmatism with the “plus” cylinder.

Results. After 6–15 years, astigmatism changed in 85 % of the examined eyes: it increased in 7 eyes (averagely, by 0.3 D) and decreased in 53 (averagely, by 0.9 D, p < 0.05; with the maximum reduction of 2.75 D). The spheric-equivalent refraction changed in 51 % of eyes, with an average increase of 0.53 D. The maximum increase of refraction was 2.8 D, while the maximum drop was 1.4 D. Visual acuity of the children who wore the prescribed eyeglasses permanently, showed after two years an increase, average achieving the level of 0.84, which by the end of the follow-up period achieved 0.99.

Conclusion. The proposed plan of mixed astigmatism correction, which preserves residual weak myopic defocus, fully ensured both tactical and strategic effects: prevention and elimination of amblyopia, and containment of refraction myopization.

The effectiveness of nutraceutical drug containing oxycarotenoids, vitamins and trace elements, aimed at inhibiting the progression of the dry form of age-related macular degeneration (AMD) has been demonstrated in clinical studies.

The purpose of this research is to evaluate the effectiveness of long-term use of a nutraceutical drug in reducing the risk of intermediate AMD evolving into wet AMD, and assess whether it is worth using in patients with wet AMD to reduce the average yearly number of intravitreal injections of angiogenesis inhibitors.

Materials and methods. In the first part of the study, we monitored 46 patients with intermediate AMD threatening the progression of the disease (those with multiple confluent drusen, drusenoid, pigment epithelium detachment) for a year: some of them received the drug while others had no nutraceutical support. We assessed standard visual functions, as well as reading parameters (on the Salzburg Reading Desk device), spatial frequency contrast sensitivity (SFC) according to the Zebra program, and macular pigment optical density (on the MPOD device). Retina parameters were controlled by photofixation using Kowa and Clarus 500 fundus camera, and by optical coherence tomography with angiography using a Cirrus 5000 Angioplex, Carl Zeiss. The disease was considered to be progressing if signs of neovascular AMD were detected. In the second part of the study, 35 patients with newly diagnosed neovascular AMD were followed up for a year and treated with angiogenesis inhibitors according to the following pattern: three loading injections of aflibercept and then pro re nata. Of two groups of patients with signs of neovascular AMD, one group took a nutraceutical drug (Lutrin, S.C. Rompharm Company S.R.L., Romania). The number of intravitreal injections of aflibercept administered according to indications during the year was estimated.

Results. In the first part of the study, patients with intermediate AMD taking the drug showed an increase in MPOD from 0.36 ± 0.11 to 0.45 ± 0.15 (p = 0.05) and a stable state of the retina and visual functions throughout the entire observation period. In 2 patients (12.5 %) who did not take the drug, the disease progressed to a neovascular form. In the second part of the study, the patients taking the drug received an average of 3.4 ± 0.7 intravitreal injections of aflibercept during the year, compared with 5.3 ± 1.2 injections in the control group without nutraceutical support.

Conclusion. Nutraceutical drugs are effective in reducing the risk of intermediate AMD evolving into wet AMD, and thus advisable for patients with wet AMD to reduce the average yearly number of intravitreal injections of angiogenesis inhibitors.

Purpose: to evaluate the effectiveness of corneal collagen crosslinking (CCC) with a portable Keratolink device in patients with bullous keratopathy after cataract surgery.

Materials and methods. 19 patients (19 eyes) aged 60 to 87 with secondary epithelial-endothelial corneal dystrophy, developed due to cataract surgery received three CCC procedures which lasted 20 minutes each, with intervals of 2 days between the procedures.

Results. The mean corneal pain score according to verbal pain scale decreased to 4.5 from the initial 9 points and did not change significantly at subsequent visits. Optical coherence tomography data show that before the first procedure, the average corneal transparency score was 2.8 while by the 20th day of observation it fell to 1.4 points. After 3 CCC procedures, bullae continued to form in 3 patients only (3 eyes, 16 %) over the entire 3-month-long observation period. The best corrected visual acuity 3 months after CСC in patients was about 0.07 ± 0.02, which is slightly higher than the initial value (0.05 ± 0.03).

Conclusion. A short course of ultraviolet CCC with a portable Keratolink device may be recommended as a palliative treatment for elderly patients with bullous keratopathy developed after cataract surgery.

Purpose: clinical and genetic research of primary chronic angle-closure glaucoma (PACG) and age-related macular degeneration (AMD) for prospective pathogenetically-oriented targeted treatment of these condition.

Materials and methods. 15 patients with isolated ocular proliferative syndrome were divided into 2 groups depending on their diagnosis: 1) 7 patients (14 eyes) aged 55 to 83 with confirmed wet AMD (4 women and 3 men). 2) 8 patients (16 eyes) aged 45 to 80 with chronic PACG (5 women and 3 men). The patients were followed up for 1 to 3 years.

Results. In both conditions, we found mutations in the genes of the Russian population involved in the process of proliferation: VEGF A, CFH, and COL11A1. We developed an algorithm of bioinformatic analysis of full-exome/full-genome sequencing data which takes account of the aggregate of clinical and genetic data and helps refine the prognosis of the course of proliferation. Genetic markers remain unchanged throughout the patient’s life, so it is important to conduct these studies in old age.

Conclusion. To prevent the proliferative syndrome in patients with chronic PACG and AMD, and develop individual targeted pathogenetic therapy schemes for these diseases, specialized molecular genetic tests are needed, the results of which could be analyzed with the developed algorithm.

Purpose: to compare the regenerative activity of benign and malignant conjunctival tumors.

Material and methods. The study was performed on 86 tumor biopsies from patients with a clinically diagnosed conjunctival neoplasm. Healthy tissues from the same eye were taken as a control sample. The optical density of the reaction mixture containing biogenic nanoparticles formed in the presence of conjunctival tumors and the corresponding paired healthy tissue samples from the control group was measured by spectrophotometry. The data obtained were later verified by a pathohistological analysis.

Results. A significantly higher level of in situ formation of biogenic silver nanoparticles was recorded in the reaction mixture with malignant tumors of the conjunctiva (3.0 ± 1.1, (n = 32) compared to benign tumors (1.3 ± 0.2, n = 54). No differences were found between various types of benign tumors. In samples of malignant tumors, the indicators of recovery activity in melanoma (3.4 ± 1.0, n = 14) and lymphoma (2.8 ± 1.0, n = 7) were significantly higher than in squamous cell carcinoma (2.0 ± 0.6, n = 11), but no significant differences were found between the two types of tumors.

Conclusion. The method of spectrophotometric measurement of the regenerative activity of conjunctival tumors can be used in preoperative or intraoperative diagnostics thanks to the fact that the results can be obtained rapidly, which will help to quickly determine the extent of surgical intervention needed and optimize the treatment tactics.

Purpose: to analyze intraocular fluid (IOF) cytokine concentrations in patients with diabetic macular edema (DME) after intravitreal therapy with angiogenesis inhibitors or corticosteroids (CS).

Materials and methods. 44 patients (45 eyes) were divided in 2 groups depending on the therapy: group 1 (n = 19) received an angiogenesis inhibitor (aflibercept) while group2 (n = 26) received CS (dexamethasone implant). They were tested for IOF cytokine levels by Milliplex® Map Human Cytokine/Chemokine Panel at treatment start and 3 months after either 3 monthly injections of aflibercept or a single dexamethasone implant injection.

Results. The concentrations of ten cytokines (IL-8/CXCL8, IP-10/CXCL10, MCP-1/CCL2, PDGF-AA, GROα/CXCL1, VEGF-A, MIP-1β/CCL4, IL-15, IL-7, IL-6) were found to fall significantly in both groups of therapy. IL-6 and IL-5 levels showed the most significant drop as compared to other cytokines, with a more pronounced decrease in the aflibercept treatment group. In both groups, VEGF-A concentration showed a significant drop, and the share of the eyes that responded to the treatment was 94.7 % in the aflibercept therapy group and 96.2 % in in the dexamethasone implant group.

Conclusion. The IOF concentration assessment of a number of pro-inflammatory cytokines/chemokines shows that both the anti-VEGF agent — aflibercept and CS — dexamethasone implant contribute to a decrease of inflammation which is observed 3 months after the start of treatment.

A clinical case of viral conjunctivitis COVID-19, which was complicated by partial symblepharon and severe dry eye syndrome, is presented. The latter was treated for several days with eye drops containing solutions of glucocorticosteroid, a cytostatic and an antiseptic combined with tear replacement therapy, which however led to an extensive detachment of the corneal epithelium of the right eye, a superficial ulcer and an area of keratomalacia in the lower part of the cornea. In view of this, a further hospital treatment was required: the patient received anti-inflammatory and keratoprotective drugs. A subsequent medical consultation found out that the patient had periodically instilled oxybuprocaine hydrochloride 0.4% into the right eye for pain relief for a long time (4 months) without informing the attending physician. As a result of hospital treatment, the condition of the patient’s right eye improved: the corneal ulcer, was epithelialized, followed by the formation of a vascularized corneal leukoma. In our opinion, a deterioration of the tear film stability of the patient, who had had COVID-19 accompanied by ocular manifestations in the form of initially developed conjunctivitis, was due to the anesthetic effect of long-term instillations of oxybuprocaine hydrochloride. This led to a significant decrease in tear secretion, a decrease in the density of goblet cells of the conjunctiva and a violation of the sensory innervation of the cornea, which gradually brought about a severe dry eye syndrome. The above case clearly demonstrates the importance of increasing the patients’ awareness of the harm that could be caused by long-term use of local anesthetics without a doctor’s approval.

The main symptoms of solar maculopathy are central visual acuity decrease, the onset of central scotoma, photophobia, metamorphopsia and dyschromatopsia. In the acute period, the ophthalmoscopic picture of the disease requires a differential diagnosis with hereditary cone retinal dystrophies. An objective differentiation of these diseases is possible by fluorescein angiography, electrooculography, and optical coherence tomography of the retina. The paper presents a clinical case of solar maculopathy with an analysis of differential diagnostics used.

Preliminary data show that the incidence of eye damage in COVID-19 reaches 32%, with a diverse range of clinical manifestations. Both the anterior segment of the eye (conjunctivitis, keratoconjunctivitis) and the posterior segment (retinal vascular thrombosis, neuritis, neuroretinitis) can be affected. The infection in children is diagnosed much less frequently than in adults, so ophthalmic manifestations have hardly ever been studied.

Purpose: to present cases of congenital eye lesions in children born to mothers who had COVID-19 during pregnancy.

Material. We present 4 clinical cases of ocular manifestations in newborns born to such mothers.

Results. 4 variants of congenital ocular manifestations are reported. Clinical manifestations are listed, and treatment tactics for such patients is proposed.

Conclusion. In order to timely diagnose, and choose the optimal treatment tactics of such conditions, thorough collection of case history and the ophthalmologists’ awareness of ocular symptoms of COVID-19 manifestations is essential.

Pleomorphic sarcomas (PS) are a heterogeneous group of poorly differentiated malignant neoplasms of mesenchymal origin affecting various organs and tissues, which account for 5–7% of all malignant soft tissue tumors. PS most often affects the soft tissues of the extremities, while being extremely rare in the orbital region and the eyeball. The final diagnosis is given after a histological and immunohistochemical (IHC) test of PS supplemented by a cytogenetic test in some cases. The differential diagnosis is based on histogenetic types determined. It should be noted that clinical, instrumental or morphological differential diagnosis between PS of the eye and melanoma is sometimes extremely difficult. The paper presents a case of eyeball PS with an invasion into the orbit, providing a detailed description of the clinical signs of disease, the results of macroscopic, histological and IHC tests of the surgical material, and a review of the literature discussing this pathology. Given the rarity of PS of the eye, the description of the clinical case may be of interest to ophthalmologists and oncomorphologists.

This review provides a detailed summary of the issues of etiology, pathogenesis and molecular mechanisms of corneal neovascularization. Signaling molecules involved in the process of neovasculogenesis, as well as their antagonists, antiangiogenic factors, are described. The role of signaling proteins VEGF, MMP and their receptors as modern targets of therapy is described on the basis of a series of clinical studies. The potentials of gene and bioengineering therapy as a promising method of treating corneal neovascularization are presented.

Retinal structural plasticity is manifested in multiple damages of the retina. In many cases, the response to these damages is identical at both the cellular and molecular levels, involves similar sets of cellular signals, and is associated with a change in the structure of the retina and remodeling of the neural connections. The review discusses the common and specific features of adaptive and non-adaptive retinal plasticity, which characterize glaucoma, age-related macular degeneration, retinitis pigmentosa, diabetic retinopathy, and retinopathy of prematurity. Given the common features of neurodegeneration and retinal plasticity in brain and retinal diseases, similar therapeutic strategies can be used in many cases to preserve the structure connectivity and retinal function, which stop or slow down the clinical evolution of the disease by either suppressing primary events or enhancing compensatory and regenerative mechanisms in the nervous tissue. Part 2 of the review will present neuroplasticity-based modifying therapy methods for retinal degenerative diseases.

The symptoms of most pathological conditions in ophthalmology are based on inflammations of varying severity. Valuable tools against inflammation are topical glucocorticoids (tGCs), whose molecules are able to actively overcome biological membranes and ensure a rapid clinical response. The use of tGCs is accompanied by a wide range of effects, including side effects, a rise in intraocular pressure being one of the most significant ones. The review focuses on a comparative analysis of the efficacy and safety of various tGCs, including “soft steroids”. We show the relationship between the structure of the drugs, their pharmacodynamic effects and the possibility of being used in various eye diseases.

The review summarizes the evidence of visual and neurological complications in the acute stage of COVID-19 and in post-COVID syndrome. Neurological symptom complexes, and cerebrovascular disorders are described. Ophthalmologic manifestations may be a typical sign of COVID-19 onset, but they may also develop several weeks after recovery. The spectrum of neuro-ophthalmological manifestations in most cases includes optic neuritis, optic disc edema, optic neuropathy, and venous thrombosis. Ophthalmologists should be aware of the possible associations of ocular diseases with COVID-19 in order to diagnose and initiate an early treatment for life and vision threatening complications.

The challenge of the coronavirus pandemic, and the research into the mechanism of development of the symptom complex that appears in patients who had COVID-19 (post-COVID syndrome), is a topical issue of modern medicine. Obviously, as the incidence of COVID increases, the number of patients suffering from the post-COVID syndrome increases, too. According to recent estimates, 10 to 20 % of patients who have experienced an acute symptomatic phase of SARS-CoV-2 suffer from the effects of the disease over 12 weeks from the primary diagnosis. COVID-19 has been shown to have a variety of long-term effects on virtually all body systems, including the eye. The ocular surface can serve as a gateway for the virus to enter the body, so that patients experience nonspecific changes in the conjunctiva, cornea, retina, and eye vessels. Thus, the issues of diagnosis and treatment of the COVID-19 infection itself and, notably, its complications and conditions that have arisen and continue after the disease, are of essential research and clinical interest. SARS-CoV-2 has a negative impact on the state of the vascular wall and contributes to the development of hypercoagulable conditions, which increases the risk of thrombosis and possible complications in the cardiovascular system. The review summarizes the analyses of eye vessels blood flow in patients who have undergone COVID-19.

The literature review focuses on penetrating macular holes, a topical issue in vitreoretinal surgery. Multiple theories and the modern view on the pathogenetic mechanisms macular hole formation are presented. A classification of macular holes is proposed.