For many centuries, enucleation was the only method of treating Choriodal melanoma CM, and, despite the development of many organ-preserving methods, it has not lost it’s relevance today. In recent years, microRNAs, which began to receive attention from the beginning of the 2000s, now play the role of biological markers in many diseases both in diagnosis and in assessing the effectiveness of treatment. There are only a few studies on the significance of circulating microRNAs as a marker of the effectiveness of surgical treatment of cancers of certain locations (breast, lungs). As for uveal melanoma, there is practically no such information in the literature.

The purpose of the work is to determine the effectiveness of enucleation as a surgical method for treating large choroids, based on the nature of the expression of microRNA-223, microRNA-27b, microRNA-155 in the blood plasma of patients in M0N0 stage.

Material and methods. 83 patients with CM aged 61.5 ± 10.9 years (22–83 years) were examined. The thickness of the MC varied from 2.23 to 22.00 mm (on average 9.32 ± 3.97 mm). The control group consisted of 28 volunteers aged 45–78 years (average 62.90 ± 1.42 years). The expression pattern of microRNA-223, microRNA-27, microRNA-155 in the blood plasma of patients was determined by quantitative polymerase chain reaction before and over a period of 3 to 54 months after surgery.

Results. In all patients the expression pattern showed overexpression of all microRNAs compared to the control group at different periods of the study, starting from 3 months. During observation, 6 patients were diagnosed with liver metastases. A comparison of the study results in this group before and after enucleation with a group of patients without metastases showed an increase in the expression of a panel of microRNAs during the development of metastases.

Conclusion. Enucleation remains the operation of choice in patients with large choroidal melanomas at the M0N0 stage. Control of the nature of the expression of microRNA-223, microRNA-27b and microRNA-155 in the blood plasma of patients makes it possible to personalize the indications for enucleation.

Choroidal neovascularization (CNV) in children is a rare but functionally significant complication of a wide range of fundus diseases. Data on the effectiveness of antiangiogenic therapy for CNV of various etiologies in ophthalmopediatrics are scarce.

Purpose of the study is to analyze the effectiveness of antiangiogenic therapy for CNV in children.

Material and methods. A retrospective analysis of the results of treatment of active CNV was performed in 54 children (59 eyes). All patients underwent intravitreal injection of antiangiogenic drug (ranibizumab, aflibercept or brolucizumab). In addition to standard ophthalmologic examination, children underwent optical coherence tomography (OCT) and OCT angiography (OCTA) of the macular area and optic nerve head at diagnosis and dynamically after treatment.

Results. In 51 children (56 eyes), persistent suppression of CNV activity was achieved, in 3 children the drug administration was continued on an “as needed” basis. The number of anti-VEGF drug injections ranged from 1 to 7 (on average, 1.6 ± 1.3), while 8 children (8 eyes, 13.6 %) required more than 2 injections of the drug, in 6 of them the main disease was inflammatory lesion of the uveal tract and retina. The best corrected visual acuity in 20 children (20 eyes, 33.9 %) increased by 0.03–0.4, in 30 children (35 eyes, 59.3 %) it remained stable, in 4 children (4 eyes, 6.8 %) it decreased by 0.05–0.6.

Conclusion. Anti-VEGF therapy is an effective method for treating CNV in children. Further studies are needed to identify risk factors and develop treatment regimens for refractory cases of CNV.

Purpose: to determine the risk factors of the inflammatory reaction in the anterior chamber aqueous humor in routine cataract surgery of patients with concomitant ophthalmological and systemic pathology based on a quantitative assessment of the eye anterior segment optical coherent tomography (OCT) data.

Material and methods. The study enrolled 60 patients aged 38 to 85 years, 45 % of them were men. Before planned phacoemulsification, a standard ophthalmological examination, the eyelids status assessment, parameters of the lacrimal meniscus, calculation of cell in the anterior chamber using OCT were performed, also general clinical data were analyzed. 2 groups were analyzed: group 1 — risk group — 30 patients with symptoms of inflammatory reaction according to a blood test, paraocular foci of chronic infection and diabetes mellitus, as well as those who had chronic blepharitis, group 2 control — 30 patients without these signs. Biomicroscopy and anterior segment OCT were performed before and 4 hours after the surgery, as well as on days 1, 7, and 14.

Results. Group 1 patients had cytosis of 2.5 cells (0-20) in the anterior chamber humor at the preoperative stage. Cells were detected in 57.58 % of cases (p = 0.000), but in no case in group 2. In the first hours after surgery, the same frequency of humor opalescence fibrinoid reaction and ophthalmohypertension was observed in the groups, but the frequency of corneal tunnel edema in group 1 was significantly higher (p = 0.048). In the first hours after the intervention, the cell suspension in the aqueous humor was more intense in patients of the risk group; in all cases the number of cells progressively decreased and leveled out between the groups. Correlation analysis showed the relationship between the severity of cell suspension and opalescence of the anterior chamber humor with the presence of cytosis at the preoperative stage (R = 0.88, p = 0.002), the type of IOL chosen (R = 0.74, p = 0.021) and the presence of diabetes mellitus in history (R = 0.82, p = 0.007).

Conclusions. Usage of precise imaging techniques to assess anterior chamber humor cytosis is a convenient, objective, and reliable method. The presence of cell suspension in the anterior chamber aqueous before surgery, especially in elderly patients with diabetes mellitus, is a prognostic factor for a more expressed inflammatory reaction of the anterior segment in uncomplicated phacoemulsification.

Purpose. To evaluate the possibility of removal of epiretinal fibrosis (ERF) with complete saving of the internal limiting membrane (ILM) to reduce the risk of iatrogenic intraoperative trauma associated with the procedure of ILM removing, and postoperative complications associated with retinal nerve fiber layer damage developing as a result of ILM removing.

Material and methods. The study included 54 patients with ERF, whose average age was 69.5 years. In the course of surgical treatment, it was planned to remove the epiretinal membrane (ERM) with an attempt to completely ILM saving. In all cases, after removal of the vitreous, epiretinal structures were stained with MembranBlue Dual and ERM was removed, trying to completely ILM saving. The anatomical result was evaluated according to optical coherence tomography. The functional result was evaluated according to the indicators of best corrected visual acuity (BCVA). The maximum follow-up period was 12 months.

Results. It was possible to remove the ERM with complete ILM saving in 26 (48.14 %) patients, in 28 (51.86 %) the ERM was removed in a single unit with the ILM. In all cases, the postoperative period proceeded without peculiarities and complications. At a follow-up examination after 3 months, all 54 patients showed an increase of BCVA compared to preoperative value. There was no BCVA decrease in any case during this follow-up period. In cases of the ERM removal with the ILM saving in the long-term postoperative period (12 months), no recurrence of ERF was recorded, as in cases where the ILM was removed.

Conclusions. It was possible to reduce intraoperative retinal injury due to the ILM saving during the ERM removal in 48.14 % of cases, using standard vitreoretinal instruments and techniques. According to the study, the ILM saving does not lead to a recurrence of ERF in the long-term postoperative period.

Purpose: to analyze the efficacy and safety of Santabrim® as a starting monotherapy and when added to combination therapy for glaucoma.

Material and methods. The study was conducted on 60 patients (60 eyes), including 21 (35 %) men and 39 (65 %) women, with initial or advanced primary open-angle glaucoma with moderately elevated IOP. The average age of patients was 63.4 years. The first group (30 eyes) consisted of patients who were prescribed Santabrim® 2 times a day as a starting monotherapy. The second group consisted of patients (30 eyes) who had an enhanced regimen using Santabrim® 2 times a day as a third drug. To analyze the hypotensive effect, the data of corneally compensated IOP were compared at the first visit and 1 month after the appointment or enhancement of the local hypotensive regimen. Safety was assessed by comparing the degree of fluorescein staining of the cornea, conjunctival hyperemia, OSDI questionnaire indicators and the level of adherence to treatment at the appropriate time in two groups of patients.

Results. Santabrim® significantly reduces the level of IOP. The use of the drug as monotherapy allows to reduce IOP by 26.3 % of the initial level. Strengthening combination therapy by adding Santabrem® as a third drug allows reducing the level of IOP by an additional 15.9 %. Objective indicators of the condition of the tissues of the anterior surface of the eye have not changed significantly. Based on the results of the assessment of the main signs of dry eye syndrome (OSDI) and the degree of patient adherence to treatment, no significant changes were revealed.

Conclusion. Brimonidine 0.1 % (Santabrim®) can be recommended for the hypotensive treatment of glaucoma both in monotherapy and in combination with other groups of local instillation drugs, and its direct neuroprotective effect additionally contributes to the stabilization of glaucoma opticoneuropathy.

Purpose: to evaluate the long-term results (1 year) of a new method of treating amblyopia in children with unstable central and eccentric fixation using microperimetric biofeedback, as well as to develop a protocol for patients monitoring after treatment and clear criteria for prescribing repeated courses of treatment using microperimetric biofeedback.

Material and methods. The study included 21 patients (21 eyes) aged from 5 to 15 years (ave 8.28 ± 3.08) who were able to perform training sessions on the MP-3 microperimeter (MP, Nidek, Japan). Treatment was carried out on the MP using visual (flickering checkerboard pattern) and sound (sound signal) biofeedback: 10–15 sessions, 10–12 minutes each. All patients were examined before treatment, immediately and 1, 3, 6 and 12 months after the treatment. Dynamic observation of patients and prescription of repeated courses of treatment were carried out in accordance with the developed protocol.

Results. After 1 course of treatment, a significant increase in best-corrected visual acuity (BCVA) was detected in 90.4 % of patients, as well as an improvement in all fixation parameters: a significant increase in density by 2° and 4°, a decrease in amplitude by ≈ 50 %; a tendency to increase the functional parameters of the retina in the macular area. During follow-up (1 year), 13 patients (1 patient with central fixation and 12 patients with eccentric fixation) underwent additional courses of biofeedback therapy in accordance with the developed protocol. In 4 patients with eccentric fixation, mainly peripheral, despite improvement in fixation parameters, no additional positive dynamics in visual acuity were noted after a repeated course of biofeedback therapy. In 8 patients, after a repeated course of treatment of amblyopia using biofeedback therapy, positive dynamics were noted, namely: an increase in density and a decrease in the amplitude of fixation, and an increase in BCVA.

Conclusion. The effectiveness and safety of a previously developed method of treating amblyopia with impaired fixation mechanism using biofeedback therapy has been demonstrated. A protocol for dynamic monitoring of patients with amblyopia after biofeedback therapy and criteria for prescribing additional courses of training sessions have been developed.

Purpose: to evaluate the functional results of using the Monofocal+ intraocular lens for cataract surgery in comorbid conditions of the eye.

Material and methods. The study included 31 patients (45 eyes) with cataracts. Patients underwent cataract phacoemulsification with implantation of ICB00 Eyhance IOL. The operation was performed on the TECNIS platform (Johnson & Johnson), based on Em, according to the Kane and Barrett Universal II formulas. Patients were divided into 3 study groups (15 eyes each) according to concomitant ocular pathology: primary open-angle glaucoma IIa, age-related macular degeneration, non-proliferative diabetic retinopathy, dry form of intermediate stage. Each study group, using a retrospective analysis of data from patients operated on over the past 2 years, was divided into two control subgroups: in one of them, patients underwent implantation of a monofocal IOL (SA60AT AcrySof, Alcon), and in the other — an EDOF IOL (DFT015 AcrySof IQ Vivity, Alcon).

Results. Uncorrected visual acuity of 66 cm in patients with the Eyhance IOL was significantly higher than with the SA60AT IOL for all considered comorbid conditions (p < 0.05). Uncorrected visual acuity at near distance (33 cm) had a clear advantage in patients with the Vivity IOL compared to others (p < 0.05). The Eyhance IOL had uncorrected visual acuity of 0.23, and the SA60AT IOL had a value of 0.2. Uncorrected visual acuity at 33 cm in patients with Eyhance IOL with concomitant glaucoma was significantly higher than in patients with SA60AT IOL (p < 0.05), however, no different from those with age-related macular degeneration and non-proliferative diabetic retinopathy (p>0.05). All patients with the IOL Monofocal+ expressed their satisfaction with the vision they received, which was reflected in the results of the VF test-14 QOL questionnaire.

Conclusion. New generation monofocal IOLs showed good functional results in patients with cataracts and the considered comorbid pathology of the eye: primary open-angle glaucoma II a, intermediate stage of the dry form of age-related macular degeneration, non-proliferative diabetic retinopathy. There is a relatively high visual acuity at distance and at intermediate distances, and good patient satisfaction with the resulting vision. To clarify the indications and contraindications for the IOL Monofocal+ use in patients with various concomitant ophthalmopathologies more long-term clinical observations and analysis of implantations are required.

Purpose. To study of the effectiveness of cataract surgery based on the results of a comprehensive evaluation, including the patient's opinion about the state of visual functions, when assessed using a questionnaire before and after surgery.

Material and methods. 117 patients (117 eyes) diagnosed with nAMD and cataract (LOCS I — 56 patients, 47.9 %; LOCS II — 57 patients, 48.7 %, LOCS III — 4 patients, 3.4 %), mean age 76.2 ± 5.7 years were included in the study. All patients received angiogenesis inhibitor therapy (aflibercept 2 mg), in Treat&Extend regimen. Cataract surgery was performed if disease activity is controlled. A questionnaire including 10 questions was developed to interview patients, 9 of which were assessed before, 1 and 6 months after cataract surgery, and a 10th question on patient satisfaction with the results of surgery — 1 and 6 months after cataract surgery.

Results. There was a significant improvement in functional (increase in BCVA by 0.31 units from the baseline) and anatomical parameters (significant decrease in CRT, height of neuro- and pigment epithelium detachment), as well as in patients' assessment of vision-related quality of life. The most compromised aspect before surgery was the ability to read text in newspapers, books, and magazines. After surgery there was a significant improvement of the indicators characterizing the patient's adaptation to navigation and outside activities. There were minimal changes in central vision loss and metamorphopsia as assessed by patients (on average, by 0.02 b. and 1.21 b.). 99 patients (84.0 %) reported satisfaction with the results of the surgery. The strongest correlations (r = 0.94 and 0.81, p < 0.05) characterized the relationship between patients' evaluation of the effect of surgery and the presence of central vision spotting/loss of central vision, double vision.

Conclusion. The results of surgery significantly contribute to the patient's assessment of his/her daily activities requiring clearer vision, primarily in the middle and far distances. Cataract surgery does not worsen the course of nAMD and, on the contrary, cataract surgery and continuation of antiangiogenic therapy contribute to a significant improvement in BCVA and anatomical improvement.

Purpose of the study is to determine the zones of standard keratometry according to keratotopography data, which will allow for more accurate calculation of multifocal IOL using 10 formulas.

Material and methods. The study included 55 patients (55 eyes) who underwent phacoemulsification of cataract or refractive lensectomy with femtolaser accompaniment, implantation of multifocal IOL (Acrysof IQ PanOptix) and achieved the target refraction at different distances. Retrospective calculation of the optical power of the IOL was carried out using biometric data from OA-2000 and keratometric indicators of Pentacam (zones from 0.5 mm to 5 mm in increments of 0.5 mm on the Axial/Sagittal map centered on the apex and pupil) using 10 formulas (SRK/T, Holladay 1, Holladay 2, Haigis, Hoffer Q, Barrett 2 Universal, Olsen, Kane, EVO ver. 2.0, Hill RBF ver. 3.0). For each combination of zone/keratometry value/formula, the average error of postoperative predicted refraction, its difference from zero (Wilcoxon criterion), the median value taking into account the sign, the mean (MAE) and median (MedAE) absolute errors in calculating the spherical equivalent of the IOL, the standard deviation of the mean absolute error (SD) were calculated.

Results. All formulas had a shift to myopic refraction, except for the Haigis formula, which shifted towards hyperopia. The absence of a significant difference from zero was shown only by the Kane formula in zones 3.5, 4.5–5.0 mm when centered on the apex and in zones 0.5, 1.5, 2.5–5.5 mm when centered on the pupil. The highest values of MAE were found in Haigis and Olsen formulas, and the minimum values were observed in most formulas in the 4.5–5.0 mm zones. The lowest MedAE values in all ranges were shown by the formulas Kane, EVO, Holladay 1 and Holladay 2. The minimum SD values were found for the formulas Kane, EVO, Holladay 1 and Holladay 2.

Conclusion. The Kane formula turned out to be the most accurate in the 4.5–5.0 mm zone. This is followed by the EVO 2 and Holladay 1 formulas in the 4.0 mm zone. The Haigis formula turned out to be the least accurate. The remaining formulas can be recommended for use with SimK Pentacam data in 4.0–5.0 mm zones.

Purpose: a comparative study of the main characteristics of the anti-inflammatory effect of the ophthalmic dosage form (ODF) of bromfenac — the drug Broxinac and analogues, their local bioavailability, biodistribution and intraocular pharmacokinetics during the inflammatory process in the anterior segment of the rabbit eye.

Material and methods. The studies were performed on 40 sexually mature male rabbits of the “Soviet Chinchilla” breed with an experimental model of carrageenan anterior uveitis. The anti-inflammatory and local irritant effect on the cornea, bioavailability and intraocular pharmacokinetics in the anterior chamber humor of ODF - bromfenac drops with various auxiliary components when instilled into the conjunctival sac were determined.

Results. Broxinac, containing 0.05 mg/ml benzalkonium chloride as an auxiliary substance, exhibits more pronounced anti-inflammatory properties than existing analogues containing benzalkonium chloride at a concentration of 0.01 mg/ml or not containing it at all. The drug does not cause a local irritant effect when administered every 12 hours for 10 days 1 drop into the conjunctival sac of the eye of an awake rabbit, only minor signs of irritation in the form of closing of the eyelids in some rabbits were noted. When using comparison drugs containing 0.01 mg of the aforementioned preservative, the severity of the local irritant reaction fluctuated in a fairly wide range: from moderate to pronounced. It was established that the dosing form of Broxinac creates high peak concentrations in the anterior chamber humor and vitreous body, which remain within the therapeutic limits for at least 12 hours regardless of the presence of uveitis, with a half-life from the anterior chamber humor, depending on the presence of pathology, from 79 to 89 minutes.

Conclusion. The ability of auxiliary components to change the pharmacology of the dosing form is the basis for optimizing the local bioavailability and pharmacodynamics of bromfenac as the active substance of the drug Broxinac. An increase in the concentration of benzalkonium chloride to 0.05 mg / ml (which is 5 times higher than that of the selected analogues) facilitates the passage of bromfenac through the tissue barrier of the eye and prevents presystemic elimination.

Purpose of this study is to identify selected single nucleotide polymorphisms (SNP) of the PAX6 gene and to assess their correlation with congenital iridofundal colobomas and other congenital ocular anomalies.

Material and methods. It was a case-control study done on 45 patients aged from 75 days to 58 years (mean age 29.36 ± 14.4 years) with irido-fundal coloboma and 45 healthy controls aged 35.23 ± 13.92 years. Ocular examination was done by using slit-lamp microscopy inspection, fundoscopy and intraocular pressure measurement. Genotyping was done by using the polymerase chain reaction — restriction fragment length polymorphism (PCR-RFLP) method.

Results. Two irido — fundal coloboma patients showed CT (+/-) heterozygous genotype of rs667773 SNP and the rest were wild-type CC (-/-) homozygous genotype. All controls showed CC-/- wild-type homozygous genotype. PAX6 SNP rs3026354 showed CC (-/-) wild-type homozygous genotype condition in all patients. Neither CG (+/-) heterozygous nor homozygous GG (+/+) genotype was reported in patients and controls. SNP rs662702, genotype pattern was CC-/- wild type homozygous in all patients and controls. CC genotype frequency was 95.56 and CT genotype was 4.4% while C allele frequency was 97.78 and T allele frequency was 2.22 % in rs667773 C>T SNP. rs3026354C>G SNP had 100 % CC genotype and C allele frequency in both case and control populations. SNP rs 662702C>T showed 100 % CC genotype and C allele frequency in the case and control respectively.

Conclusion. The elevated frequency of the CC genotype with C allele was more common in irido fundal patients. Two heterozygous CT genotype of rs667773C>T SNP were reported in two irido-fundal coloboma patients.

Purpose: to evaluate the content of tissue inhibitor of matrix metalloproteinase type 1 (TIMP-1) in platelet preparations obtained in different methods.

Material and methods. Platelet-rich plasma (PRP), platelet-poor plasma, and a suspension of platelets washed from plasma (WP) were isolated from the blood of 10 volunteer donors, and a morphofunctional analysis of platelets was performed. After that, a platelet lysate was prepared from PRP, WP, and platelet-poor plasma. The concentration of TIMP-1 in the lysates was determined using enzyme immunoassay.

Results. The level of TIMP-1 in the lysates of PRP and WP did not differ significantly; in platelet-poor plasma, the level of TIMP-1 was significantly lower than in the lysates of PRP and WP (p = 0.003). In all types of preparations, the concentration of TIMP-1 was 2-4 times higher than similar values in the blood serum of healthy people, as reported in other studies. A weak correlation was found between the TIMP-1 concentration and the platelet number in PRP, and there was no correlation between the content of platelets with granules and the TIMP-1 level in the lysates. The presence of leukocytes in the initial PRP also did not affect the TIMP level in the final lysates. A strong correlation was found between the TIMP-1 concentration in the WP lysate and in platelet-poor plasma, as well as a direct correlation between the total platelet content and the TIMP-1 level in the PRP lysate.

Conclusions. Preparations with high concentrations of TIMP-1 can be obtained both from concentrated platelet suspensions and from platelet-poor plasma. To optimize the method, it is necessary to study the effect of platelet preparations with TIMP on various biological models.

A clinical case of optic neuritis in a patient with idiopathic thrombocytopenic purpura is presented. As a result of a comprehensive ophthalmological, clinical, instrumental and laboratory examination, objective signs of unilateral demyelinating damage of the optic nerve were revealed (according to the results of electrophysiological examinations and optical coherence tomography). A year later the patient developed a clinical symptoms of multiple sclerosis, confirmed by magnetic resonance imaging. Associations of multiple sclerosis with other autoimmune diseases are not uncommon, however, only a few cases of multiple sclerosis on the idiopathic thrombocytopenic purpura have been described in the literature. Considering that ophthalmologists in clinical practice may encounter concomitant eye diseases on the diagnosed or debuting autoimmune diseases, it is necessary to conduct an ophthalmological examination with immediate consultation of related specialists.

A clinical case of removal of a giant foreign body (FB) from the orbit one year after a traumatic pistol injury simultaneously with enucleation of the eyeball is described. Particular attention is paid to the difficulties of diagnosis and surgical technique in removing giant FBs. Computed tomography (CT) is the main method of examination for such injuries, but it should be borne in mind that FBs, especially bullets from traumatic pistols, can consist of various materials, including X-ray negative ones. In addition, large metal fragments produce significant artifacts that complicate the interpretation of the CT image.

Spontaneous delivery is a natural process. But some pathological conditions can lead to dangerous consequences for the health of the mother and child in the process of physiological childbirth. In this case, there are indications for operative delivery, which may be accompanied by a number of complications. In accordance with the clinical guidelines of the Russian Federation in 2021, there are no absolute indications for operative delivery from the ophthalmological side. At the same time, some experts strongly recommend cesarean section for certain ophthalmic conditions. The objective of this review was to consider the validity of the concerns of obstetricians and gynecologists regarding some common diseases of the eye during spontaneous delivery.

The review article presents current data on the microbiota (MBT) of the ocular surface in infectious and inflammatory eye diseases. Saprophytic MBT increases the resistance of the ocular surface to pathogenic bacteria. Commensal microorganisms regulate host metabolism, immune system development, and defense of the host against pathogen invasion. Meanwhile, ocular surfaces can change due to various environmental factors, processes in the human body, and in particular, due to ophthalmological diseases. Damaged epithelium of the cornea and conjunctiva (e. g. caused by dryness, the use of contact lenses, antibiotics, etc.) can lead to an increase in the number of bacteria on the ocular surface and disruption of the protective film containing antimicrobial compounds that lubricates the epithelium. In recent years, a connection has been shown between changes in the composition of the ocular MBT and a number of infectious and inflammatory ophthalmological diseases. In particular, it turned out that factors influencing the formation of tear fluid can change the MBT of the ocular surface, and when its composition deteriorates, ocular surface may become dry. An increase in the number of pathogenic microorganisms when wearing contact lenses, especially gram-negative ones, can lead to changes in the MBT and the development of keratitis. In inflammatory eye diseases, gram-positive microflora is most often isolated (in 94 % of cases), of which coagulaze negative staphylococci are most often recorded. In bacterial eye infections. conditionally pathogenic microflora often occurs (44.5 %). Apparently, intestinal MBT plays a very significant role in the development of some inflammatory eye diseases such as anterior and posterior uveitis.

Micropulse cyclophotocoagulation (MP-CPC) refers to interventions that reduce intraocular pressure by laser exposure on the ciliary body, while the term “coagulation” in its name does not reflect the essence of the procedure, but is inherited from the previous continuous laser version. Unlike other methods that target ciliary body, MP-CPC is considered the safest procedure due to its special laser action mode and the absence of a coagulative effect. In the first part of our review, we would like to focus on the history, mechanisms of action and procedure protocol of micropulse cyclophotocoagulation.

Glaucoma is a leading cause of blindness in the world. A proven condition for preventing the progression of glaucomatous optic neuropathy is to reduce intraocular pressure. Therapy begins with local hypotensive drugs; if they are ineffective, laser treatment or surgery is used. However, hypotensive intervention does not guarantee a stable hypotensive effect. Wound healing is a complex physiological dynamic process that is necessary to maintain homeostasis in the body. This process includes three interrelated phases: inflammation, fibroplasia, and remodulation (maturation) of the scar. Thе review presents various cellular mechanisms involved in the regulation of these processes and factors that contribute to excessive scarring. The review presents various cellular mechanisms involved in the regulation of these processes and contributing to excessive scarring. Current knowledge about the key factors of pathomorphological processes occurring in the filtration zone is intended to stimulate the development of new methods for prolonging the effect of filtering surgery.

Bacterial infection is one of the etiologic factors of inflammation of the uvea. Bacterial agents capable of provoking the development of uveitis are numerous and diverse (Gram-positive and Gram-negative; bacilli, cocci, and flagellates; aerobic and anaerobic). It is important to note that bacterial infection can cause uveal inflammation through several pathogenetic pathways. Direct exposure to microorganisms and products of their vital activity is only one of the realized pathological influences. The pathogenetic mechanisms of uveal inflammation development are not completely clear, but the leading role is currently attributed to activation of Toll-like and Nod-like receptors by bacterial antigens with subsequent triggering of a cascade of reactions leading to the production of inflammatory cytokines. In addition, a significant role is given to autoimmune processes, as a result of which cross-reactivity to bacterial antigens and similar antigens of the ocular vasculature develops. The peculiarities of pathogenesis provide the peculiarities of the clinical picture of bacterial uveitis, which is characterized by granulomatous type of inflammation. The exception is uveitis developing due to the predominance of autoimmune component in the development of the disease, which determines pathomorphological nongranulomatous type of inflammation. In this review immunologic mechanisms of bacterial uveitis development are given, pathogenesis of syphilitic, tuberculous, post-streptococcal uveitis is considered in more detail. Pathomorphologic and clinical features of bacterial uveitis are described. The role of modern drugs in the treatment of bacterial inflammation of the ocular vasculature is evaluated.

Herpes simplex viruses type 1 and 2 (HSV-1 and HSV-2) cause widespread lifelong infections. These characteristics of herpes simplex virus infections (HSVI) are associated with the presence of two phases in the infectious cycle: the lytic infection phase, which involves the formation of new viral particles, and the latent infection phase, during which the HSV remains in cells in a hidden form that is less accessible to the immune system. The lytic and latent phases of HSVI differ in the form of the viral genome, its localization, number of active viral genes, and expressed viral products. Lytic infection primarily occurs in epithelial cells, while the reservoir of latent virus is the nuclei of sensory neurons of the ganglia innervating the site of lytic infection. “Abortive” infection of Hela transfected cells is considered as experimental analogue of latent neuron infection, in which HSV-1 genomes were detected in the nuclei of surviving cells for up to 5 weeks, retaining the ability to reactivate and induce lytic infection. Frequent subclinical reactivation of HSV with the release of infectious virus has been identified in individuals who have had herpes infections and in healthy people with chronic HSVI. Relapses of herpes disease occur much less frequently. Intercurrent diseases are one of the leading factors in the reactivation of latent HSV. Reactivation of HSV can trigger the exacerbation or development of non-herpetic diseases, complicating their course. Inclusion of specific antiviral agents in the complex therapy of such patients shortened the time till remission onset. HSV reactivation is a prognostically unfavorable factor not only in active eye disease but also in clinical remission. According to our data, subclinical HSV reactivation in patients with remission of uveitis increased the systemic production of pro-inflammatory and angiogenic chemokines, thus contributing to the chronicization of a low-grade inflammatory process and the development of late post-uveal complications. The question of prescribing specific antiviral therapy to such patients remains relevant.

The modern pathogenesis of the neurodegenerative process in glaucoma identifies several key risk factors for its development: ischemia/hypoxia, mitochondrial dysfunction, oxidative stress and neuroinflammation. An analysis of recent studies shows that in glaucomatous optic neuropathy, as in other neurodegenerative diseases, the immune system is involved in the pathological process, and immunoregulation is carried out mainly by retinal glial cells, microglia, astrocytes, Müller cells and the complement system. Chronic activation of glial cells caused by increased intraocular pressure in glaucoma can provoke a pro-inflammatory state at the retinal level, causing disruption of the blood-retinal barrier and death of retinal ganglion cells. The review presents pro-inflammatory markers of glaucoma, immunomodulatory and pro-inflammatory mediators, shows the role of a number of metalloproteinases and their tissue inhibitors, as well as pro-inflammatory cytokines in the development of glaucoma.

Latanoprost, an analogue of class F2α prostaglandins, has been on the glaucoma hypotensive treatment market for almost 30 years, being the drug of first choice due to its high efficiency, good tolerability and minimal dosage. The drug is effective in all ages and is approved in pediatric practice from 1 year. According to numerous studies, latanoprost monotherapy can reduce IOP by an average of 22–39 % from the initial level over several years; a decrease in the hypotensive effect over time has not been noted. Latanoprost is compatible with all other groups of antiglaucoma drugs, demonstrating an additive effect.