In Russia, a complex approach to diabetes mellitus and diabetic retinopathy (DR) treatment is adopted, yet certain issues remain in the system of medical care for DR patients. The statistical data are important to assess the availability and quality of medical care in each region of the Russian Federation, to plan resource distribution, and determine the volume of medicinal and technical support. The article presents an analysis of the territorial differences of DR prevalence and of dispensary follow-up of DR patients. In order to eliminate certain territorial defects in the organization of medical care for such patients, an improvement of outpatient medical aid organization and a more effective interaction between ophthalmological and endocrinal health services is required.

Purpose. To study how filtration blebs change in the postoperative period after applying the innovative patented suture during sinus trabeculectomy (STE).
Material and methods. 105 patients (105 eyes) with primary open-angle glaucoma were randomized into 2 gender and age matched groups. In group 1, the conjunctival wound was sutured with separate continuous sutures on the conjunctiva and the Tenon's capsule. In group 2, the wound was sealed according to an innovative method. Before surgery, patients underwent a comprehensive examination, including visometry, tonometry, perimetry, and retinal tomography. In the postoperative period (1 day, 1, 2 weeks, 1, 3, 6 and 12 months after the STE), the changes of filtration blebs characteristics were assessed using the Würzburg bleb classification score (WBCS).
Results. In group 2, one day after the surgery, IOP showed a decrease 0.8 mm Hg greater than in group 1. One month after surgery, the decrease was 1.5 mm Hg greater. The difference in IOP levels between the study groups persisted for up to 1 year (with a significant difference of 3.6 mm Hg after 3 months, and 3.8 mm Hg after 1 year, p = 0.001). The development of intraoperative and early postoperative complications was generally comparable. In group 1, an additional suture sealing was required in 11 8 % of cases due to external filtration. In group 2, no additional sutures were required (p = 0.01). The two groups revealed differences in the degree of vascularization of the conjunctiva and in the presence of conjunctival microcysts, as well as in the degree of encapsulation (p < 0.001) Group 2 treated by the innovative suturing technique showed better results.
Conclusion. The innovative method of applying a sealing suture after STE quickens the normalization of the main characteristics of filtration blebs in comparison with the control group within 1 year after the intervention.

Familial exudative vitreoretinopathy (FEVR) is a hereditary disease characterized by abnormal angiogenesis and avascular zones (AZ) on the retinal periphery. The leading method of treatment of its early stages (1–3) is laser coagulation (LC) of AZ and pathological retinal vessels.
Purpose. To study the efficiency of retinal laser coagulation in children with various stages of FEVR.
Material and methods. 65 children with FEVR (82 eyes) were observed after retinal LC for 6 months to 10 years (on average, 3 years). The efficiency of laser treatment was evaluated after 2–3 months. We regarded the result as stabilization if no progression of the disease could be observed over the entire follow-up period (at least 12 months), either with or without an additional LC.
Results. The efficiency of a single LC in children with FEVR in stage 1 was 100 %, in stage 2, 50 to 56 %, in stage 3, 10 to 50 %, in stage 4, 20 to 33 %. The proportion of cases with long-term (over 12 months) stabilization after additional LC sessions was diminishing according to the initial severity of clinical manifestations: from 75–100 % in stages 1–2 to 41–60 % in stage 3 and to 17–20 % in stage 4.
Conclusion. LC efficiency of AZ and pathological retinal vessels in children with FEVR is inversely proportional to the stage of the disease. In more than half of the cases, repeated sessions of LC are required to achieve stabilization. The persistence of vascular activity after LC or the appearance of new vascular malformations are prognostic signs of further FEVR progression. The results obtained indicate the need for an early detection of the disease and an LC procedure to prevent the development of extensive retinal detachment, as well as regular dynamic observation of the patients and further study of the pathogenetic mechanisms of FEVR progression.

Purpose: to evaluate the effectiveness of transscleral micropulse cyclophotocoagulation (mCPC) in patients with end-stage glaucoma.
Material and methods. 38 patients aged 76.6 ± 7.1 years with end-stage refractory glaucoma were examined, revealing subjective complaints, uncompensated IOP at the maximum hypotensive mode, prior multiple surgical interventions. Indications for mCPC to be performed on a SUPRA 810 device (Quantel Medical, France) according to a modified protocol, in which the laser energy flux is 121.8 J/cm2, were determined. In order to prevent postoperative inflammation after mCPC, a combined drug Floas-T® (glucocorticosteroid fluorometholone + tobramycin) was used.
Results. A week after mCPC, the hypotensive effect was achieved in all 38 cases. IOP showed a 30.8 % decrease from the baseline. Considering an additional mCPC given to 14 patients, the entire group showed an IOP 22.8 % decrease (from 34.7 to 26.8 ± 2.9 mm Hg, p < 0.05) achieved after an 18 months’ follow-up. The combined drug Floas-T® was found to contribute to a subjective and clinical improvement, revealing no signs of an increased IOP.
Conclusion. The use of mCPC in the treatment of patients with repeatedly operated refractory end-stage glaucoma who receive a maximum hypotensive mode should be estimated as a positive measure. The combined drug based on fluoroquinolone and tobramycin has demonstrated high effectiveness of anti-inflammatory prevention. A survey showed a subjective improvement in the patients’ quality of life. The mCPC method can be recommended as one of the components of a comprehensive rehabilitation program for patients with end-stage glaucoma.

Purpose: to analyze morphometric, clinical and functional manifestations of glaucomatous optical neuropathy in congenital childhood glaucoma (CG).
Material and methods. We examined 103 children (163 eyes) with (CG), including 54 children (86 eyes) with primary congenital glaucoma (PCG) aged 1 month to 17 years. In addition to the regular ophthalmological examination, we performed optical coherence tomography of the optic nerve head (ONH), flash visual evoked potentials, total and rhythmic electroretinogram, oscillatory potentials (OP), echobiometry of the eye axial length.
Results. The thickness of the retinal nerve fiber layer peripapillary (pRNFL) ranged from 32 to 120 μm, averaging 71.67 ± 18.2 μm. The thinning was detected in 83.0% of cases, primarily in the temporal sectors (90.6%). As the condition progressed, a tendency to progressive thinning of the RNFL was detected. The minimum rim width (BMO-MRW) ranged from 87 to 336 μm and was reduced in most children (14 out of 16, 87.5%). A strong inverse correlation of the neuroretinal rim with the depth (r = -0.69) and the width (r = -0.93) of the excavation was detected. Also, a strong direct correlation was established between the minimum neuroretinal rim width reduction and the thickness of the BMO-MRW and pRNFL (r = 0.79), as well as the upper and lower temporal sectors (r = 0.81 and r = 0.88, respectively). The thickness of the ganglion cell (GC) layer varied from 8 to 23 μm and averaged 14.64 ± 4.89 μm, with a reduction recorded in most cases (64.7%). All patients showed a decrease in oscillatory potentials (OP) by 40% or more (6.31 ± 2.33) as compared to the control group (20.24 ± 6.28). Thinning of the RNFL was registered in these eyes in 90.6% of cases averagely (p < 0.05) and in the upper and the lower temporal sectors (p < 0.05).
Conclusion. RNFL thickness, the minimal width of the BMO-MRW and the OP are the most sensitive criteria to assess the degree of glaucomatous optic neuropathy in children with PСG. The study of the GC layer thickness can serve as an additional diagnostic criterion of assessing the state of the ONH.

Purpose. To evaluate the possibility of predicting the anatomical and functional results of surgical treatment of traumatic retinal detachment (RD) in trauma of various geneses, taking into account the clinical picture and the severity of the proliferative syndrome based on large clinical data.
Materials and methods. A comprehensive analysis of the clinical picture (using 22 features) and long-term results of surgical treatment of 427 patients with traction traumatic RD (TRD) after open and closed eye injury was carried out. The patients were divided into 7 groups depending on the mechanism of injury. The observation period was 5 years.
Results. The most severe proliferative syndrome was observed in TRD after an open injury: OEI A (contusions with scleral rupture), OEI D (double puncture wound) and OEI E (explosive trauma with scleral rupture), when both the process of mooring and PVR are present, as well as with CEI A (contusion) in the event that after the first operation PVR continued to progress. We found a direct dependence of PVR activity in TRD on the area of the detached retina and the presence of a traumatic cataract, and the inverse dependence on the presence of intraocular foreign body (IFB), its size and the ability of IFB to cause metallosis. A direct dependence of long-term functional results of treatment on the PVR stage, the area of detached retina and the diagnosed retinal rupture during the first vitreoretinal surgical intervention was established.
Conclusion. In order to make the surgical treatment of TRD more effective, it is worth using antiproliferative drugs intravitreally during vitreoretinal surgery, especially in OEI A, OEI D and OGI E, when the proliferative syndrome is caused both by PVR and mooring, as well as in CEI A in the case of a pronounced PVR stage.

The importance of early detection and monitoring of retinal diseases determines the relevance of the study devoted to the diagnosis of retinal pathologies by OCT images using artificial intelligence (AI) tools.
The purpose is to develop algorithms for diagnosing retinal pathologies from OCT images by machine learning methods.
Material and methods. The study used a dataset (20,000 eyes), publicly available on the Internet, which contains OCT images of healthy retina (5,000 eyes) and retina affected by three different pathologies (choroid neovascularization, macular edema, multiple drusen, 15,000 eyes). The retinal pathology recognition system is based on a trained neural network VGG16 (developed by a visual geometry group of Oxford University).
Results. The main result of the research is the development of an algorithm, implemented on Python, for the diagnosis of retinal diseases from OCT images based on convolutional neural network AI tool. The sensitivity and selectiveness of the neural network model during the diagnosis of retinal diseases were 97 and 98%, respectively.
Conclusion. AI methods used in the retinal pathology automatic detection system developed at the Helmholtz National Medical Research Center of Eye Diseases as part of automated medical decision-making system have been shown to have high potential and efficiency. In the future, this service can be used to improve the effectiveness of early diagnosis and monitoring of retinal diseases in conditions of reduced availability of primary ophthalmological care in some of the territories of the Russian Federation, including that provided at the pre-doctoral stage.

Purpose: to study the prevalence of various chronic infections, the frequency of their reactivation and characteristic associations of microorganisms in patients with optic neuritis of various etiologies.
Material and methods. 13 patients with optic neuritis (ON) and 12 patients with ON and multiple sclerosis were tested for a broad range of infectious agents in their blood serum.
Results. All patients were shown to have mixed infections; 64 % of them had an association of 4 or more infectious agents. The patients of both groups were infected with Epstein-Barr virus (100 %), Cytomegalovirus (92 %) and Herpex simplex viruses (92 %) types 1 and/or 2 with serological signs of their reactivation. The combination of Herpes virus reactivation, Toxoplasma and urogenital infection was more often detected in patients with demyelinating ON. In patients with multiple sclerosis, a mutual correlation was detected: the higher the degree of infection (combination of 5 or more pathogens), the lower the visual acuity at the onset of the disease (p < 0.05) and the less favourable the vision prognosis.
Conclusion. Possibly, mixed infection may play an important role in the pathogenesis of ON, including that of demyelinating etiology, as a trigger or an aggravating factor.

Purpose: to determine the efficacy and safety of fixed latanoprost/dorzolamide combination Dorzoprost in hypotensive treatment of primary open-angle glaucoma (POAG) patients previously treated with latanoprost.
Material and methods. An observational study included 30 patients (37 eyes) with moderate and advanced POAG who had uncompensated elevated IOP receiving latanoprost monotherapy. During the screening visit, latanoprost was switched to Dorzoprost instilled once in the evening. The targets were IOP, visual acuity, MD and PSD perimetry indices, retinal nerve fiber layer thickness, minimum width of the neuroretinal rim, macula retinal nerve fiber layer thickness, and adverse events. The observation period lasted 12 weeks. IOP was measured at weeks 4 and 12.
Results. After 4 weeks, a statistically significant decrease in IOP was noted, which remained stable at 12 weeks. The average additional IOP decrease of those treated with Dorzoprost was 17%. Statistically insignificant positive changes were registered in visual acuity, static perimetry and optical coherence tomography. By the end of the observation period, 6 cases revealed a decrease in the degree of conjunctival hyperemia, while all dry eye syndrome cases (5 patients) showed a decrease in the severity of the signs of the syndrome.
Conclusion. Dorzoprost has a significant additive hypotensive effect and a favorable safety profile.

Late complications of radial keratotomy (RK), are as a rule caused by a change in the biomechanical properties of the cornea.

Purpose: to study the long-term stabilizing effect of the Bowman’s layer (BL) transplantation after RK.

Material and methods. In a limited, prospective, monocentric pilot study we operated 2 male patients (2 eyes) aged 60 and 55. The radial incisions had been performed 34 and 38 years ago. The indications for surgery were progressive biomechanical instability of the cornea and functional refractive visual fluctuations. Within 12 months after the operation, complications, corrected visual acuity, keratometric parameters, biomicroscopic transparency of the cornea, and patient satisfaction were assessed.

Results. No complications were noted during the follow-up period, the cornea and graft retained transparency. The average thickness of the BS graft was 20±2.1 µm. The average visual acuity corrected by contact lenses increased from 0.4±0.3 to 0.65±0.1, the average indicator of keratometric astigmatism changed from 1.9±1.6 to 3.0 D, these indicators remained after 6, 9 and 12 months, which indicates that biomechanical stability of the cornea was achieved and that the refractive-visual fluctuations are absent.

Conclusion. In late term RK complications, BS transplantation partially restores the normal anatomy of the anterior surface of the cornea and ensures its biomechanical stability during a 12-month follow-up period. For the conclusions to be maximally objective, more clinical cases should be studied within a longer observation period.

To assess the role of multifocal electroretinography (mf-ERG) in preclinical diagnosis of tumor-associated distant maculopathy in small choroidal melanoma (CM) of extramacular localization.
Material and methods. 35 patients (35 affected and 35 fellow eyes) with small CM of extramacular localization and 23 healthy volunteers (46 eyes) aged 59.67 ± 14.2 years were given general ophthalmological examinations and mf-ERG. Density (nV/deg2), culmination time of the P1 component and amplitude (μV) of the N1 component were measured for 5 response rings (R1–R5) at different distances from the fixation point: central hexagon R1: 2.3° (fovea zone); R2: 2.3–6.9° (parafovea); R3: 6.9–14.3° (perifovea); R4: 14.3–20.8° and R5: 20.8–29.9° (middle periphery areas of the retina).
Results. Eyes affected by CM showed a decrease in the density of the P1 component in the R1 hexagon by 25.7% of the normal values (p = 0.03). The fellow eyes showed an increase in the density of the P1 component in the R2 ring (p < 0.05). The peak latency of the P1 component in the R1–R5 rings in the affected and fellow eye was found to elongate by 30–45% (p < 0.05). The amplitude of the N1 component in the central hexagon of CM-affected eyes increased by 12.96%, whilst in the R4–R5 rings it decreased by 36–45% as compared with healthy individuals (p < 0.05). The fellow eye showed supernormal values of the N1 amplitude in R1 and its suppression in R4 and R5 rings (p < 0.05).
Conclusion. The mf-ERG method is useful for preclinical diagnosis of tumor-associated distant maculopathy in small CM of extramacular localization. Changes in mf-ERG of the fellow eye in patients with small CM have been documented.

Effective treatment of HIV-infected patients has changed the previous view of the clinical picture of cytomegalovirus uveitis (CMV uveitis).
Purpose: to determine the prevalence and structure of clinical forms of CMV uveitis in HIV-infected patients.
Material and methods. 66 patients (97 eyes), aged 39.6 ± 3.91, were diagnosed with stage 4c HIV infection. In 35 patients (53%), the duration of infection exceeded 5 years, in 13 patients (19.7%), it exceeded 10 years, and another 13 patients (19.7%) had the condition for over 15 years. The ophthalmological follow-up of patients diagnosed with CMV uveitis ranged from 6 months to 13 years (the median of 45.5 months).
Results. By the time CMV uveitis was detected, the median CD4 cell count was 34 cells/μL (the norm being 570–1100 cells/μL). The content of whole blood CMV DNA was 2.43 lg copies/10⁵ cells. The main form of the disease was chorioretinitis, diffuse and generalized forms of the disease were diagnosed in 68.0% of cases. In predicting visual acuity, the leading regression criterion was the clinical form of the disease.
Conclusion. Diffuse and generalized forms of the disease prevailed in clinical practice. The prevalence of chorioretinal lesion determined visual acuity, which in 39.2% of the eyes met the criteria for blindness according to the WHO classification (1977)

Purpose: to assess morphological and functional parameters of the eyeball in patients with neovascular glaucoma (NVG) and diabetic macular edema (DME) after vitreoretinal interventions.
Material and methods. This study involved 60 patients (60 eyes), aged 59 ± 12 including 34 men and 26 women. The patients were divided into three groups: group 1 — 19 patients (19 eyes) with NVG and DME after a vitreoretinal surgery (VRS) for proliferative diabetic retinopathy performed no earlier than a year ago. If DME was found within 6 months after the surgery, a drug was administered intravitreally (3 loading injections given with monthly intervals). The patients’ history contained cataract phacoemulsification with an implantation of an intraocular lens (IOL). Group 2 (23 patients, 23 eyes) consisted of persons with stage III primary open-angle glaucoma (POAG) with the duration of the glaucomatous process of up to 5 years, who received no laser or surgical antiglaucomatous interventions. The history of these patients also contained phacoemulsification operations with IOL implantation. Group 3 (18 patients, 18 eyes), which was composed of patients with pseudophakia but no symptoms of glaucoma or other eye pathology, served as control.
Results. The opening of the anterior chamber angle (ACA) in NVG (group 1) was 2.73 times smaller (p = 0.034) than in POAG (Group 2) and 3.69 times smaller than in the control group (p = 0.034). Neovascularization of the iris and the ACA could primarily be seen in patients with NVG (84 %). Goniosynechiae in the ACA of group 1 patients were seen 6.35 times more often than in group 2 patients and 14.45 times more often than in group 3 patients. Rubeosis occurred in group 1 patients 4.65 times as often as in group 2 and 6.64 times more often than in group 3 patients (p = 0.034). Statistically significant differences of morphometric parameters of the optic disc between groups 1 and 2, on the one hand, and group 3, on the other hand were found. Meanwhile, the figures for groups 1 and 2 were statistically comparable, which is explained by the same degree of severity of the glaucomatous process in these groups. The analysis of indices of computer perimetry MD, MS and sLV showed a developed glaucomatous process in groups 1 and 2. The revealed changes are based on pathognomonic factors. In particular, they may be caused by the prior surgical intervention affecting the vitreoretinal interface in group 1 patients.
Conclusion. The onset of NVG is primarily caused by a grave course of proliferative diabetic and changes in the ACA profile, due to the formation of synechiae. Regardless of the risk factors, the result of surgical treatment depends on the condition of the ischemic retina and the anterior segment of the eye. Thus, the assessment of the morphofunctional parameters of the eye in patients with NVG and DME after VRS is of great interest. Changes in such parameters as the degree of openness of the ACA, distance from the iris to the IOL, the presence of rubeosis and synechia may be used to determine the methods and tactics of surgery, which will eliminate the pathophysiological factors of the onset and progression of CVH, and reduce postoperative complications.

Purpose: to compare the effectiveness of conventional preserved amnion and amnion saturated with platelet-rich (PRP) plasma lysate for the treatment of persistent corneal erosions (PCE) after high-risk keratoplasty.
Materials and methods. 40 patients with persistent corneal erosions after high-risk penetrating keratoplasty, followed up for 12 months, were divided into two clinical groups of 20 people each. The main group of patients, aged 34 to 84, received Flexamer amniotic membrane + PRP lysate, while the comparison group, aged 41 to 80, received Flexamer amniotic membrane only. Amniotic membrane coating was used in persistent corneal erosions of penetrating keratoplasty after unsuccessful conservative treatment. The amnion was sewn 2 mm from the limb with a continuous suture and covered with a soft contact lens. As a source of platelets, we used the blood of healthy volunteers, from which platelet-rich plasma with platelet concentration of over 1000 thousand/µl was taken, which was then frozen at -40 °C and defrosted at 0…4 °C to obtain PRP lysate. The criteria for evaluating the effectiveness of both groups were the times of epithelialization, the number of amniotic membrane coatings, and the number of preserved transplants at the end of the follow-up.
Results. Lyophilized amniotic membrane saturated with autologous PRP lysate growth factors was shown to be biocompatible. It was found to be safe for the patients, to reduce the epithelialization time, to reduce the number of operations required to cover the PÑE with the amnion, and to increase the likelihood of successful transparent and translucent engraftment of a penetrating keratograft.
Conclusion. The use of a lyophilized amniotic membrane enriched with growth factors of autologous PRP lysate is a promising method for the treatment of PCE of the penetrating corneal graft after high-risk keratoplasty.

Purpose: to present our experience of surgical treatment of peripheral retinoschisis without macular involvement using a scleral buckle.
Material and methods. 31 patients (31 eyes) with peripheral retinoschisis (PR) without macular involvement, including 19 cases complicated by retinal detachment, underwent scleral buckling with cryoretinopexy of rupture zones and vitreoretinal degeneration and transscleral drainage of subretinal fluid.
Results. In 12 (39 %) cases, the retina reattached within 24 hours after the operation, in 11 (35 %) cases, it reattached within 1 week, while in 8 (26 %) cases complete resorption of the subretinal fluid and retinal reattachment occurred 1 to 6 months after the operation. By the end of the 6-month follow-up period, retinal reattachment was achieved in all cases.
Conclusion. The surgical treatment tactics of PR without macular involvement by scleral buckling is effective and pathogenetically validated, especially in the case of progressing lretinoschisis.

Ophthalmic herpes is the most common infection-related cause of blindness in developing countries.
Purpose: to evaluate the therapeutic efficacy, safety and tolerability of the drug Panavir® used as part of a combination therapy for herpetic superficial dendritic keratitis.
Materials and methods. The study involved 106 patients aged 18 to 65 years divided into two groups. Group 1 (54 patients; 54 eyes) received treatment with Panavir® and Acyclovir ophthalmic ointment, whilst Group 2 (52 patients; 52 eyes) received a placebo of Panavir® and Acyclovir ophthalmic ointment. The primary parameter of the efficiency was the percentage of patients achieving clinical recovery, i.e. signs of complete epithelialization of the cornea.
Results. In group 2 (monotherapy), a significantly greater number of patients with mild conjunctival hyperemia was registered than in the combination therapy group 1 — 59.26 vs. 23.08 %, p < 0.001. In group 1, the proportion of patients without corneal syndrome at visits 3 and 4 was, respectively, 11.11 and 61.11 %, while in group 2 it was only 3.85 and 19.61 %, respectively.
Conclusion. The drug Panavir® eye drops 0.004 % showed a high therapeutic efficiency in the combined treatment of herpetic keratitis, and good tolerance. It also reduced the time required for corneal epithelialization and conjunctiva normalization.

Purpose. To evaluate the efficacy and safety profile of an innovative ab-externo technique in the management of uncontrolled open angle glaucoma (OAG) through creating filtering tracts subconjunctivally.
Material and methods. This is a randomized clinical trial including 40 eyes (40 patients) divided into 2 equal groups, group (A), underwent ab-externo radiofrequency sclerostomy and group (B), underwent ab-externo radiofrequency sclerostomy with subconjunctival injection of mitomycin C. Intraoperative and postoperative complications, visual acuity, intraocular pressure (IOP) and bleb status were evaluated for 6 months.
Results. The mean preoperative IOP was 28 ± 3.5 mm Hg reduced to 21.9 ± 5.2 mm Hg (p = 0.001) in group (A) and was 29.4 ± 3.4 mm Hg reduced to 20.8 ± 6.3 mm Hg (p = 0.001) in group (B), 6 months postoperatively. Both groups showed a significant percent reduction of IOP 15.1 ± 17.3%, 27.1 ± 22.4% in groups (A) and (B) respectively with group (B) showing lower values on days 1, 7, 14, 30, 90 and 180 but was not statistically significant. The number of anti-glaucoma medications was significantly reduced in both groups. Heat radiation to the cornea from radiofrequency waves was obvious in early cases — 5 (25%) in group (A), and 3 (15%) in group (B) that was reversible within the first 3 months postoperatively. Shallow anterior chamber and choroidal detachment were the most encountered early postoperative complication, which all managed conservatively.
Conclusion. Ab-externo radiofrequency sclerostomy offers a promising minimally invasive, quick and simple procedure in management of early and moderate cases of OAG with effective reduction of IOP and number of glaucoma medication.

Purpose: to clarify the pathogenetic classification of primary angle-closure glaucoma (PACG) based on genetic studies and retrospective analysis.
Material and methods. 28 patients (44 eyes) aged 40 to 75 years with various forms of initial, advanced, advanced and terminal stages of PACG, as well as combined glaucoma, were observed.
Results. Pathogenetically significant genetic polymorphisms responsible for synechiogenesis in chronic PACG have been found. Clinical and genetic analysis of PACG showed that the classification based on the clinical course, the mechanisms of closure of the iridocorneal angle (ICA), the distribution by stages of primary closure of the ICA, the severity of the pathological process and the level of intraocular pressure, fail to take into account the genetic characteristics of patients with PACG: these are predetermined at birth. In appositional closure of the ICA, preventive laser iridotomy is indicated, while in synechial closure, preventive iridotomy may aggravate synechiogenesis.
Conclusion. A pathogenetic classification of PACG has been proposed, which takes account of its hereditary nature. This classification, is advisable to use when choosing a treatment tactics.

Inflammatory complications of cataract phacoemulsification are among the most urgent and potentially vision-threatening conditions. Corneal melting is a rare but clinically significant condition preceding corneal perforation. The main risk factors are the use of nonsteroidal anti-inflammatory drugs (NSAIDs), severe dry eye disease and rheumatic diseases. The paper presents a literature review and offers an analysis of a clinical case of corneal melting after cataract phacoemulsification in a female patient with severe dry eye disease, which was undiagnosed before surgery. The follow-up period was 5 years. The possibilities and limitations of multiple methods of corneal melting treatment at the stages of persistent epithelial defect and corneal ulcer are discussed. The mechanism of disease development and its link with the pathogenesis of dry eye disease and the role of topical NSAIDs as a trigger for the initiation and progression of corneal melting are considered.

Purpose: to present a clinical case of secondary ametropia retreatment with flap lifting, which was performed long after a LASIK surgery.
Material and methods. A female patient who experienced a regression of the refraction effect after a LASIK surgery, received a flap lifting with keratoablation 18 years after the primary LASIK surgery. 8 days following this procedure, the patient developed a complication, namely an epithelial ingrowth. Another flap lifting procedure was performed and the epithelial ingrowth was removed.
Results. The expected refractive effect was achieved with binocular hypocorrection as planned.
Conclusion. A repeated flap lifting undertaken 3 years or more after the first LASIK or FemtoLASIK surgery increases the risk of a complication — an epithelial ingrowth into the space under the flap. To avoid the complication in such cases, the retreatment by PRK is preferable. Scarification and elimination of the in-grown epithelial should be performed early after the surgery.

The review outlines the models of keratoprostheses currently used in various countries and their effectiveness, conceptual models under development, prospects and trends in keratoprosthetics observed in the world.

We present the current trends in proton therapy of patients with intraocular malignancies as reflected in the materials of the First PTCOG ocular proton therapy symposium, held on March 3–4, 2022.

Circulatory disorders in eye vessels play an important role in the development of ophthalmic pathologies, in particular socially significant diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy, and retinal vascular occlusion. Eye hemodynamics features are an important diagnostic criterion for both ocular and systemic diseases. A comprehensive assessment of blood flow in various structures of the eyeball offers additional information on the pathogenesis of the diseases and helps develop new approaches to monitoring the effectiveness of treatment and vascular pathology prognostication. Thanks to the improved technologies, we have today a variety of invasive and non-invasive techniques for examining ocular hemoperfusion, including those intended for retrobulbar blood flow and intraocular blood circulation evaluation. The review article is focused on the state-of-the-art techniques: fluorescein angiography, ultrasound examination involving blood flow assessment by colour Doppler mapping and Dopplerography, optical coherence tomography in the angiographic mode and laser speckle flowgraphy. The role of these techniques in the diagnosis of vascular pathology and their advantages and disadvantages when used in ophthalmological practice is considered.

Purpose: to analyse the medical and technical aspects of intraocular lenses (IOLs) with extended depth of field (EDOF). Literature analysis was performed in the PubMed international database, the search keywords being “IOL with extended depth of field” (EDOF), “Optical Bench Evaluation of IOL”, “Preclinical evaluation of IOL”, “Aberrations”, “Monofocal IOL” (MOFIOL), “Multifocal IOLs” (MUFIOL). A total of 226 sources were analyzed, further using systematic review filters and the authors' knowledge of the topic. The duration of the retrospective analysis was 7 years (2016–2022), some of the considered work dates back to 2023. Unlike MUFIOL, EDOF lenses create a single elongated focal point to increase the depth of field, rather than several foci. Thus, EDOFs are aimed at reducing light phenomena, glare and halos, the occurrence of which is characteristic of MUFIOL. A potential disadvantage of EDOF is the reduction in retinal image quality with an excessive increase in the number of aberrations. The factors of the medical and technical assessment of the IOL indicate a high correlation with the predicted visual acuity (VA). EDOFs, whose design features are based on a higher order aspherical design, provide comparable optical quality for the far and extended intermediate ranges, while producing halo effects comparable to those of MOFIOL. Designed to improve depth of field with a full correction of corneal spherical aberration, EDOF provides intermediate-level pupil-independent improvement in VA and maintains visual acuity unlike conventional MOFIOLs. The quality of visual perception and the predicted VA of various types of EDOFs depend on the optical technology and the correction of corneal spherical aberrations. EDOFs can be expected to provide adequate vision at an intermediate distance (with a possibility of insufficient near vision). At the same time, the expansion of the depth of field varies between models, which should be taken into account when preoperatively choosing EDOF for a specific type of daily visual activity of the patient, especially for people with visually strenuous work. The results of the medical and technical assessment are widely used in the clinical testing of specific types of EDOF IOLs.

In the first part of the review [ROJ, 2023; 16 (2): 160–2], we discussed the common and specific features of adaptive and non-adaptive retinal plasticity characteristic of glaucoma, age-related macular degeneration, retinitis pigmentosa, diabetic retinopathy, and retinopathy of prematurity. The presented part of the review discusses the issues of axon regeneration of retinal ganglion cells and analyzes therapeutic approaches aimed at maximizing the plasticity and stimulating the reparative potential of the retina. The protective effects of "conditioning" stimuli in the modifying treatment of retinal diseases are considered. Some of the present-day visual rehabilitation strategies based on visual perception training and visual fixation training using biofeedback systems are reported.

Glaucoma is the top leading cause of ophthalmic-related disability in almost all Russian regions. It is a chronic lifelong disease which requires regular monitoring (once a year or more often) in a medical facility. Since the population is aging, the prevalence of glaucoma is steadily increasing, which hampers access to medical care. Advances in telecommunications and diagnostic technologies have given rise to programs of TV glaucoma, which are used to pass the basic glaucoma parameters on to a specialist working remotely for interpretation. The Federal Law No 242-FZ on telemedicine came into force on January 1, 2018, but the COVID-19 pandemic sped up the development of information technologies in medicine in general and telemedicine communication in particular. The review presents the data on TV glaucoma programs which point to their effectiveness and provides practical advice. Potentially, telemedicine can facilitate access to medical care. The analysis of the economic factors shows that remote consulting is more cost-effective than traditional face-to-face examination of the patient. TV glaucoma programs often help detect glaucomatous changes in the ONH, so more patients with suspicion of glaucoma are referred for screening.. Publications focused on the experience in using active programs contribute to their further development and introduction to the public health system, which will eventually facilitate the access to quality medical care for patients with glaucoma.

Statistics can be used to evaluate the prevalence of diseases, differences between patient groups, links between test results, compare the effectiveness of different types of treatment, test the hypothesis and model the interdependencies between variables. In medical universities, preference is given to special medical disciplines. Yet, a skilled medical specialist should have an adequate understanding of statistical data analysis. Purpose: to systematize and demonstrate statistical analysis techniques that could be useful for an ophthalmologist. Results. The major methodological aspects of statistical analysis in ophthalmology are considered. An overview of statistical techniques and an algorithm of choosing such techniques is given. Descriptive statistics and features of in-depth statistical analysis used in ophthalmological research are presented. Examples of scientific work using these methods are listed. Conclusion. The basics of statistical analysis expand the scope of instruments that ophthalmologists have at their disposal. The paper provides links to open sources in which statistical techniques and results achieved therewith are presented. These links increase the ophthalmologist’s awareness of the instruments considered.