Hyaluronic acid (HA) is a key component of the treatment of dry eye syndrome. The cross-linked HA has improved mechanical and rheological properties compared to conventional HA, which ensures a longer stay on the eye surface. Modern products with cross-linked HA provide longer-lasting hydration and with a lower frequency of instillations. However, for effective treatment of dry eye syndrome (DES), it is important to additionally stabilize the lipid layer of the tear film (TF) to reduce its evaporation. Okostill Ultralong is a new generation of longacting moisturizing eye drops due to its innovative composition which has an effect on all layers of the TF. It contains three active ingredients: cross-linked high molecular weight HA, phospholipids and propylene glycol.

Purpose of the work: to study the efficacy and evaluate the safety of using Ocostill Ultralong in patients with mild to moderate DES in comparison with Gilan Comfort (0.18% sodium hyaluronate solution).

Material and methods. The clinical observation included 80 patients (160 eyes) with mild and moderate DES. The patients were randomized into 2 groups, in which the efficacy and safety of two tear substitutes with different formulations were compared 40 min after the first instillation and after 30 days of daily use.

Results. After long-term use (30 days) of moisturizing drops of a three-component composition containing phospholipids and cross-linked HA, patients noted a decrease in the severity of dry eye sensations by 69%, a feeling of “sand” in the eyes by 88.6%, lacrimation by 90%, and hyperemia by 81%. Also in this group, was noted an increasing TF stability in 34.5% in the short term and in 41.7% after 30 days of regular use.

Conclusion. The combined effect of 3 components in the composition of moisturizing drops: cross-linked HA, phospholipids and propylene glycol, helps to stabilize the TF by affecting all its layers (lipid, aqueous, mucin). The stability of the TF increases by more than 40% and there was a decrease of clinical manifestations of DES.

The aim of the work is to study the clinical and functional state of the eyes and complications of ROP in patients over 18 years old who applied to the Center.

Material and methods. 66 young adults from 18 to 35 years old (on average, 22.68 ± 0.58 years) with cicatricial retinopathy of prematurity were examined. All patients underwent a comprehensive ophthalmological examination, including standard methods (visometry, refractometry, tonometry, biomicroscopy, ophthalmoscopy), as well as computer perimetry, EPS, ultrasound, optical coherence tomography, etc. (as indicated).

Results. Favorable outcomes (residual changes in cicatricial RP of I–III degree) were diagnosed in 78% of eyes, unfavorable (cicatricial RP of IV–V degree) — in 22%. In most cases, visual acuity was reduced — 73,5%. Refractive anomalies were detected in 97%, of which 78% were moderate and high myopia. Late complications developed in 59.8% of cases: peripheral retinal dystrophies — 55.7%, retinal detachment — 16.5%, complicated cataract — 11.4%, secondary glaucoma — 3.8%, etc. Treatment depended on the type and severity of complications.

Conclusion. All patients who had ROP in neonatal age, regardless of whether there was spontaneous regression of the disease or treatment (retinal coagulation, intravitreal administration of angiogenesis inhibitors, microsurgical interventions), should be monitored by an ophthalmologist for life and regularly. It is necessary to conduct a thorough, comprehensive examination of the anterior and posterior segments of the eye, for the purpose of early detection and timely treatment of late complications.

Comorbidity of age-related cataract and neovascular age-related macular degeneration (nAMD) is a significant problem in ophthalmological practice. The effect of cataract surgery on the course of nAMD and the effectiveness of antiangiogenic (anti-VEGF) therapy remain controversial.

Purpose: to evaluate the effect of phacoemulsification of cataract (PEC) on the course of nAMD.

Material and methods. The retrospective and prospective study included 71 patients (83 eyes) aged 77.85 ± 8.27 years with nAMD and age-related cataract. Of these, PEC with intraocular lens (IOL) implantation was performed in 46 patients. The control group (without PEC) consisted of 25 patients (27 eyes) aged 75.56 ± 6.97 years. Ophthalmologic examination included visual acuity (VA) determination, autorefractometry, biomicroscopy, fundus photography, and optical coherence tomography (OCT), including OCT-angio. Dynamic assessment of the eye condition was performed for at least 12 months before and 12 months after PEC and in the control group.

Results. Three months after PEC, there was a significant improvement in VA compared with the baseline value (mean difference 0.245; p = 0.0001; d = 1.04), which was maintained throughout the entire observation period. In the group without PEC, statistically significant changes in VA were not found over 12 months (p > 0.05). There were no statistically significant differences between the groups in the number of anti-VEGF injections during the 12-month follow-up (2.52 ± 1.96 in the group with PEC and 3.07 ± 0.83 in the control group, p = 0.23). The study of dynamic changes in retinal fluid indicates the absence of statistically significant differences in the state of the structural parameters of the retina, including central retinal thickness (CRT), of patients with nAMD who underwent cataract surgery and patients with nAMD without PEC.

Conclusion. The results of the study do not demonstrate the effect of PEC on the course of nAMD, which is confirmed by the absence of differences in the dynamics of the CRT, the state of the retinal fluid, the number of anti-VEGF injections and visual function indicators.

Deep anterior lamellar keratoplasty and penetrating keratoplasty (PKP) are the operations of first choice for pathological changes of the cornea localized in the stroma or incurable pathology of the corneal stroma. The importance of restoring corneal transparency and increasing visual acuity prevail over the well-known disadvantages of these techniques. In case of isolated corneal stroma pathology we have previously proposed a new type of closed keratoplasty – selective optical transplantation of the stroma (oSTS). The oSTS technique is devoid of intraocular complications, penetrating wound, sutures, keeps corneal surfaces intact, excludes complications related to epithelialization, optimizes rational use of available donor corneal tissue. However, as time has shown, the stromal resection stage in oSTS turned out to be technically complicated for routine and wide application.

Purpose of the study: to develop a modified (simplified) surgical technique of oSTS.

Material and methods. Modified STS (mSTS) was performed in 4 patients (age 48 ± 10 years) with lattice corneal dystrophy. The follow-up period amounted to 8.0 ± 1.3 months. Refractometry, visometry, biomicroscopy, keratoanalysis, optical coherence tomography of the cornea were performed before the operation and at fixed periods after it. We evaluated the necessity for the use of cutting instruments and the duration of extraction step of the recipient’s resected corneal stroma in both at original oSTS and mSTS.

Results. The mean duration of the extraction step in mSTS was 336.0 ± 43.7 s, whereas in oSTS it was 838.0 ± 233.5 s. No additional cutting instrument was used in the mSTS, compared to 75 % of patients in the oSTS.

Conclusion. In mSTS the duration of the most complicated stage, namely, the stage of extraction of the recipient corneal stroma, is significantly reduced, which potentially makes the technique routine and more accessible to a wide range of ophthalmic surgeons.

Purpose of the work was to investigate the state of ocular microcirculation using optical coherence tomography angiography (OCTA, Optovue RTVue XR Avanti, USA) in pregnant women with diabetes mellitus (DM).

Material and methods. The study included 113 pregnant women with DM and 60 healthy pregnant women (control group). 69 women with DM had diabetic retinopathy (DR): 49 had a progressive course and 20 had a stable course. In the superficial and deep retinal plexuses, OCTA was used to examine the vessel density indices, the area of the foveal avascular zone (FAZ), and the proportion of non-perfusion zones (our own method). The examination of patients with DM was performed in all trimesters and 3 months after delivery, and the control group was examined in the third trimester.

Results. All vessel density indices in patients with DM were significantly lower, and the proportion of non-perfusion zones in both plexuses was significantly higher (p < 0.001) than in the control group. During pregnancy and after delivery, patients with DR showed a progressive decrease in vascular density indices, an increase in PFAZ and the proportion of non-perfusion zones in both plexuses. To a greater extent, this was due to the dynamics of the studied parameters in the subgroup with DR progression.

Conclusion. The established patterns of changes in the parameters characterizing retinal blood flow during gestation and in the postpartum period in pregnant women with diabetes with stable and progressive DR can become the basis for predicting the nature of DR, facilitating early diagnosis of DR progression and determining indications for timely laser retina coagulation of such patients.

Purpose: to study and compare the dynamics of the spherical equivalent (SE) of refraction and the anterior-posterior length (AL) of the eye in children who wore spectacle lenses Stellest® with embedded rings of high-spherical microlenses Stellest® during three years of observation (main group) and in children who wore monofocal glasses for two years and switched to wearing spectacle lenses with with embedded rings of high-spherical microlenses during the third year of observation (comparison group).

Material and methods. The main group consisted of 30 children aged 8–13 years (mean age 10.50 ± 0.36 years) with acquired progressive myopia of mild and moderate degree (mean 3.15 ± 0.19 D), the comparison group — of 32 children aged 8–13 years (mean age 10.6 ± 0.2 years) with mild and moderate myopia (mean 2.68 ± 0.18 D). After 2 years of observation, 20 children in this group were transferred to spectacle lenses with with embedded rings of high-spherical microlenses. The control group included 30 children aged 10–15 years (mean age 12.60 ± 0.23 years) with myopia, who had been using monofocal glasses for the last year. The dynamics of SE cycloplegic refraction and AL of the eye were assessed.

Results. The increase in refractive error in the main group was 0.24 ± 0.07 D over 3 years and 0.04 ± 0.03 D over the third year of observation, in the comparison group — 0.99 ± 0.15 D over 3 years and 0.04 ± 0.05 D over the third year of observation. In the control group, the increase in refractive error was 0.69 ± 0.09 D over the 1 year of observation. The elongation of the AL of the eye was 0.27 mm in the control group versus 0.07 mm in the main group and 0.08 mm in the comparison group.

Conclusion. Constant wearing of glasses with embedded rings of highspherical microlenses leads to pronounced inhibition of the progression of myopia in children during three years of observation. After replacing monofocal glasses with glasses with embedded rings of high-spherical microlenses, a significant slowdown in the progression of myopia and eye growth is noted in children with myopia compared to the previous observation period.

Purpose: to examine the magnitude of pseudo-myopia in relation to preand post-cycloplegic refractive status among individuals aged 4 to 16 years and to investigate the relationship of pseudo myopia and screen time in said population.

Material and methods. Study included 66 subject’s right eyes of 48 % males, 52 % females aged 4–16 with mean and standard deviation of 10.0 ± 3.40. This comparative crosssectional study was conducted at the department of ophthalmology Tertiary Care Hospital, Islamabad. Consecutive non-randomized sampling techniques was adopted. Screen time duration in hours was measured using self-report or screen time tracking applications in smartphones. Visual acuity (VA) was measured with a standard Log MAR chart. Pre and post cycloplegic refraction with retinoscopy and Auto-refractometer were performed using Tropicamide 1 %. Paired t test was applied for pre and post cycloplegic refraction change, while Pearson correlational analysis was also calculated. Descriptive statistics were calculated using SPSS Version 21.

Results. Average screen time was 5.6 ± 1.5 hours, outdoor activity was 50.6 ± 27.3 minutes. Pre-dilation VA improved from 0.3 ± 0.3 to 0.05 ± 0.14 log MAR post-dilation. The mean spherical equivalent refractive error in pre-dilation state was –4.1 ± 2.2 D, while in post-dilation it was 0.76 ± 0.8 D. The differences were significant (p<0.01). A statistically significant relationship found between screen exposure time and pseudo-myopia (r=0.41, p<0.001).

Conclusion. Increasing screen time is associated with pseudo-myopia. Prolonged screen exposure led to increased pseudo-myopia in low myopes and hyperopes.

Purpose of the study was to evaluate the role of ophthalmological and ultrasound examination (US) in the diagnosis and evaluation of the treatment efficiency of direct carotid-cavernous fistulas (DCCF).

Material and methods. Ten patients (7 men and 3 women) aged 19 to 65 years with DCCF were examined. All patients underwent a complete ophthalmological examination and US of the cerebral and orbital vessels before and after treatment.

Results. The diagnosis of DCCF was verified by selective cerebral angiography of the cerebral vessels, which is the gold standard in the examination of patients with DCCF. Traumatic DCCF was detected in 8 patients, spontaneous DCCF was detected in 2 patients. In all patients, ophthalmological examination revealed signs of impaired venous outflow from the eye and orbit. US revealed direct and indirect signs of DCCF. Angiographic examination was combined with endovascular intervention. Reconstructive surgeries were performed in 7 patients, and deconstructive surgeries were performed in 3 patients. In the early postoperative period, all patients showed varying degrees of reduction in congestion in the eye and orbit. According to US data after surgery, all patients showed no signs of functioning of DCCF, a decrease in the size of the superior ophthalmic vein and normalization of blood flow in it.

Conclusion. A high correlation was found between the results of ophthalmological and US examination in diagnosing the DCCF and in the early postoperative period. Ophthalmological symptoms allow diagnosing impaired venous outflow from the eye and orbit. US allows visualizing signs of the DCCF, determining hemodynamic characteristics of the anastomosis and vessels involved in the pathological process, and quantitatively assessing the changes detected.

Purpose: development of a method for determining refraction in patients with altered topography of the anterior surface of the cornea.

Material and methods. The study was performed in 57 patients (114 eyes) aged 12–30 years with mild and moderate myopia, corrected by various methods: bifocal soft contact lenses (BSCL) (40 eyes), orthokeratologic (OK) lenses (30 eyes), LASIK (22 eyes), photorefractive keratectomy (22 eyes). All patients had their refraction measured using three methods: standard autorefractometry (without cycloplegia) (Tonoref III, Nidek, Japan), OPD Scan III aberrometer (Nidek, Japan) with determination of the spherical equivalent of refraction (defocus), as well as the smallest local refraction value within the pupillary zone on the vergence map (OPD). Then a duochrome test was performed (in steps of 0.25 D) with the presentation of optotypes on a red and green background. The power of the additional lens, which equally improves visual acuity on green and red backgrounds, corresponded to the clinical refraction of the eye in the BSCL, after OK correction or other types of corneal reshaping.

Results. Refractometry after OK reshaping of the cornea and in the worn BSCL gives incorrect, overestimated results in the direction of myopia. After excimer laser correction of myopia, the data of various autorefractometry methods coincide with each other and with subjective refraction. A combined method for determining refraction in patients with altered topography of the anterior surface of the cornea has been developed, consisting in a combination of two methods – aberrometry with the detection of the lowest refraction value in the pupil area and a duochromic test with correction of the obtained refraction value.

Conclusion. The developed method allows obtaining the most adequate refractive indices for users of bifocal, multifocal contact and OK lenses for myopia correction.

Age-associated diseases — glaucoma and cataract in combination with sarcopenic obesity, which develops mainly against the background of physical inactivity due to visual impairment, potentially contribute to a decrease in the activity of patients in everyday life, but the latter has not been practically assessed by special tests taking into account visual impairment. Purpose of the work is to study the effect of cataract and primary glaucoma on the daily activities of patients with sarcopenic obesity.

Material and methods. The study included 125 patients aged 60–74 years with sarcopenic obesity and immature cortical cataract stage 2 (according to the classification of clinical guidelines “Senile cataract, 2023”) with visual acuity of 0.3–0.4 and intraocular pressure (IOP) from 16 to 19 mm Hg. The study also included 138 patients of the same age with sarcopenic obesity and advanced primary open-angle glaucoma (according to the classification of clinical guidelines “Primary open-angle glaucoma, 2020”) with normalized IOP from 17 to 20 mm Hg and visual acuity of 0.3–0.4. Sarcopenia was identified using the European Working Group on Sarcopenia in Older People scale, and obesity was determined by a body mass index ³ 30 kg/m2. Activities of daily living were assessed using a specific test developed by us.

Results. It was found that cataract combined with sarcopenic obesity causes complete dependence on others (12.25 points) and has a more significant impact on everyday life than glaucoma combined with sarcopenic obesity, which causes moderate dependence (10.17 points) (p< 0.01). Statistically significant differences were found between these groups in all types of daily activities that require assistance, including nail cutting and threading a needle. Limitations in threading a needle in patients with cataracts and sarcopenic obesity correspond to 1.86 ± 0.03 points, which is significantly higher than in patients with glaucoma and sarcopenic obesity — 1.49 ± 0.02 points (p < 0.01).

Conclusion. The revealed features of visual limitations in daily activities in patients with glaucoma and cataracts combined with sarcopenic obesity should be taken into account by ophthalmologists when forming recommendations for patients' behavior in everyday life.

One of the objectives of effective ocular prosthetics is to prevent the development of pathological processes in the conjunctival cavity.

Purpose: to evaluate the effectiveness of the antimicrobial drug Mitraseptin-OftalmoLOR and its combination with the antibacterial drug MoxifloxacinOptik for the treatment of the inflammatory process of the conjunctival cavity, including bacterial conjunctivitis, in patients with anophthalmos and an ocular prosthesis, as well as the quality of life of patients during the treatment.

Material and methods. The study included 34 patients aged 22 to 77 years (mean age 49.5 ± 8.3 years), including 13 men (38.2 %); women — 21 (61.8 %) with anophthalmos and an ocular prosthesis due to a previous eye removal surgery. The patients were divided into 2 groups: Group I (n = 18) — patients with moderate inflammation without signs of bacterial conjunctivitis received monotherapy with the antiseptic Mitraseptin-OftalmoLOR, Group II (n = 16) — patients with signs of severe inflammation and bacterial conjunctivitis received combination therapy with the antiseptic drug Mitraseptin-OftalmoLOR and the antibacterial drug Moxifloxacin-Optik. The observation period was 15 days. All patients had smears and cultures taken from the conjunctiva, and a microbiological study was performed. The effectiveness of the treatment was assessed based on the analysis of the dynamics of clinical symptoms of inflammation. The safety and tolerability of the therapy were also assessed using a visual analogue scale, its impact on the change in the quality of life of patients using the WHOQOL-BREF scale. Ophthalmologic examination was performed dynamically at the screening stage (1 day), 7–8 and 14–15 days after the start of treatment.

Results. Positive dynamics of the disease was observed in all 34 cases. Patients of group I noted significant improvement after 7–8 days, clinical recovery was noted in 100 % of cases after 14–15 days. In group II, after 7–8 days of combination therapy, 7 patients (43.7 %) had a clinical picture of recovery, after 14–15 days, no signs of inflammation in the conjunctival cavity were detected in any of the patients. All patients noted good tolerability of the prescribed therapy. Antimicrobial therapy improved the quality of life of patients with anophthalmos and an ocular prosthesis.

Conclusion. The results of the study indicate high efficiency, safety and good tolerability of antimicrobial therapy using instillations of Moxifloxacin-Optik and Mitraseptin-OftalmoLOR in patients with symptoms of conjunctival inflammation and secondary bacterial infection in anophthalmos. In this case, it is advisable to prescribe a differentiated therapy regimen. The anti-inflammatory therapy regimens used in the work contributed to improving the quality of life of patients.

Purpose of the study — to identify the clinical and epidemiological features of habitual excessive accommodation (HEA) in children and to determine the key risk factors for its development and progression.

Materials and methods. A retrospective analysis of 5250 outpatient medical histories of children aged 6–17 (mean 11.2 ± 2.9 yrs), including 2865 girls (54.6 %) and 2385 (45.4 %) boys, with a diagnosis of HEA made in City Clinical Outpatient Clinic No. 29 in 2022–2024 was conducted. The main criterion for making the diagnosis was the difference between the manifest and cycloplegic refraction > 0.5 D.

Results. HEA development was noted mainly at the age of 10–13 years. The frequency of HEA detection over the three-year observation period increased from 27.6 to 39.0 %. The main symptoms of this condition are asthenopia, headaches, and decreased distance vision. Significant risk factors included heredity, perinatal damage to the central nervous system, frequent acute respiratory viral infections, and long-term use of gadgets. In 31.5 % of children, the development of low myopia was noted during the observation period.

Conclusion. HEA is a common functional disorder in school-age children. The identified risk factors must be taken into account in early diagnosis and prevention, especially in patients with a hereditary burden and unfavorable environmental conditions.

Purpose of the work is to study the relationship between the content of chemokines in the tear fluid (TF) in elderly patients with exudative age-related macular degeneration (AMD).

Material and methods. The content of chemokines in the TF was determined in 92 patients (184 eyes) aged 60-74 years with exudative AMD and in 84 patients (168 eyes) aged 60–74 years without ophthalmopathology using a certified MAGRIX (USA) device for immunoassay with Luminex technology on the xMAX platform. AMD was diagnosed based on a comprehensive ophthalmological examination and in accordance with the criteria of the classification of the Age-Related Eye Disease Study.

Results. An increase in the production of most of the chemokines under consideration was found in the TF of patients with exudative AMD compared to the corresponding indicators of individuals of the same age without ophthalmopathology: MCP-1/CCL2 up to 712.4 ± 3.4 pg/ml (reference 598.6 ± 3.1 pg/ml, p < 0.01), IP-10/CXCL10 up to 37.9 ± 2.6 pg/ml (reference 11.3 ± 2.3 pg/ml, p < 0.001), SDF-1 /CXCL12 up to 262.5 ± 4.3 pg/ml (reference 208.2 ± 4.7 pg/ml, p < 0.001), Eotaxin/CCL11 up to 6.2 ± 0.4 pg/ml (reference 4.3 ± 0.6 pg/ml, p < 0.01), RANTES/CCL5 to 1.7 ± 0.3 pg/ml (versus 0.6 ± 0.2 pg/ml, p < 0.001). At the same time, the content of chemokines MIP-1 /CCL3 decreased to 2.0 ± 0.3 pg/ml (versus 4.1 ± 0.5 pg/ml, p < 0.001), GRO /CXCL1 to 7.2 ± 0.9 pg/ml (versus 15.8 ± 2.1 pg/ml, αp < 0.001). The coefficients of multivariate regression analysis were the highest for IP-10/CXCL10 ( β = +3.538),  RANTES/CCL5  ( β = +2.859) and GRO    /CXCL1 (β  = -2.419), indicating the greatest association of these TF chemokines with the development of exudative AMD.

Conclusion. The studied TF chemokines can be used as additional diagnostic markers of exudative AMD.

Purpose. To present for the discussion the new theory of the influence of light, visual loads and mitogenetic radiation of the retina on the genetically programmed code of refractogenesis and myopia development.

Material and methods. Studies on experimental modeling of axial myopia, refractogenesis and theories of myopia pathogenesis were analyzed. Our own material included diverse studies of patients with myopia, which were conducted for more than 50 years.

Results. In experimental studies, the hereditary factor was excluded and it was established that various light effects cause axial myopia only in newborns and young individuals. However, the mechanism of the effect of light photons on the axial elongation of the eye remained unclear. The new theory of refractogenesis considers mitogenetic growth fields in eye tissues. These are fields of weak ultraviolet radiation in the range of 190–330 nm, formed during the replication of DNA chromosomes in the nuclei of cells, the division of which is stimulated by somatotropic growth hormone. The strongest mitogenetic field is formed in the retina with hyperopic defocus of light rays that pass through all its layers and are maximally absorbed by photoreceptors. This increases the activity of the mitogenetic field of the retina, which becomes the leading one and predetermines the preferential growth of the posterior part of the eye. The iridocyclocrystalline lens complex optimizes the focusing of light rays in the fovea, stimulates hydrodynamics and hemodynamics in the eye, which activates transretinal dialysis of intraocular fluid and weakens the mitogenetic field of the retina. Long-term accommodation and convergence stresses lead to the accumulation of microdeformations in the sclera, disrupt the work of mechanosensitive aquaporins, transmembrane exchange of intraocular fluid in the tissues of the eye and its transretinal dialysis, which enhances the mitogenetic potential of the retina.

Conclusion. In the postnatal period, visible light, hyperopic defocus of light rays, prolonged accommodative and convergent loads enhance the mitogenetic field of the retina, which disrupts the hereditary code of refractogenesis, leading to the development and progression of myopia.

A 60-year-old male presented with a history of binocular diplopia with decreased vision and drooping of the right upper eyelid. He had received a routine BCG vaccination one day prior to his symptoms. Though no association between the two events could be made, this case highlights the need for further studies in this regard.

Proliferative diabetic retinopathy (PDR) is one of the main causes of vision loss in diabetes mellitus. Panretinal laser photocoagulation (PRP) remains one of the main methods of treating the proliferative process in diabetic retinal damage. In 2018, a prospective randomized multicenter open-label PROTEUS study demonstrated higher efficacy of PRP in combination with intravitreal ranibizumab compared to PRP alone in the treatment of patients with high-risk PDR. This article presents three clinical cases of combination therapy for proliferative diabetic retinopathy using a Russian biosimilar of ranibizumab in patients with type 1 diabetes mellitus.

The current level of care for patients with cancer allows them to achieve remission or recovery in cases previously considered incurable. At the same time, the experience of possible side effects affecting the quality of life of patients is accumulating. In recent years, complications from the organ of vision have been described in the literature, affecting both the anterior segment of the eye, as well as the retina and optic nerve. The aim of the work is to analyze the features of the side effects of antitumor therapy of oncological diseases of various localization on the part of the organ of vision using clinical examples. Two cases of chemotherapy complications have been described: in breast cancer using tamoxifen, in diffuse B-cell lymphoma with bone marrow damage during vincristine therapy. The side effects of tamoxifen were characterized by a decrease in visual acuity in combination with crystalline deposits on the retina by the type of star shape, edema of the optic disc. The use of steroid therapy had a positive effect, visual acuity increased. The use of vincristine in the second clinical example led to damage to the optic nerve by the type of papillitis. The therapy did not lead to an increase in vision. The complications associated with vincristine therapy are dosedependent, timely withdrawal of the drug could preserve visual functions. Conclusion: the most toxic antitumor drugs for the organ of vision are alkylating agents, antimetabolites, mitosis inhibitors, hormonal agents, monoclonal antibodies, protein kinase inhibitors. The interaction between oncologists and ophthalmologists can maintain a high quality of life for patients with cancer.

Limbal-scleral staphylomas in children are a serious problem in pediatric ophthalmology, as they lead to severe consequences, including anatomical death of the eye.

The purpose of the work is to evaluate the results of a new combined method for treating limbal-scleral staphylomas in children using and local ultraviolet (UVA) crosslinking of scleral collagen (CSC) and transscleral diode laser cyclophotocoagulation (TDLC).

Material and methods. CSC was performed for 2 children aged 12 and 15 with limbal-scleral staphylomas after TDLC. Biomicroscopy, optical coherence tomography of the anterior segment of the eye and determination of the acoustic density of the sclera were used for dynamic observation of patients. The procedure of local UVA crosslinking of limbal staphylomas of the sclera was carried out using a new device for local ultraviolet crosslinking based on the permission of the Ethics Committee of the Helmholtz National Medical Research Center of Eye Diseases. The CSC procedure time was 5 min with an exposure power of 2.5 mW/cm.

Results. The use of TDLC and five local CLSC procedures combined with instillations of 0.1% riboflavin solution provided an increase in the thickness and acoustic density of the sclera, as well as a decrease in the area and height of the limbal staphyloma.

Conclusion. The first results of treating scleral staphylomas in children using a new device for local UVA crosslinking showed its high therapeutic efficacy and the feasibility of further research to advance this method into clinical practice.

The review summarizes the data of domestic and foreign studies of the lacrimal gland (LG) using various echography techniques (A-scan, B-mode, color Doppler mapping (CDM), three-dimensional echography). Despite the generally accepted standards of using computed tomography and magnetic resonance imaging to visualize orbital structures, the presence of absolute and relative contraindications limits their use. Ultrasound methods are accessible, non-invasive, and highly informative for obtaining objective parameters necessary for diagnosis and evaluation of the effectiveness of treatment of LG pathology. Modern echography methods provide important information on the anatomical, topographic and structural characteristics, biometric indicators of the LG in various pathological changes. CDM is used to determine not only the features of the LG blood supply and the state of blood flow in the retrobulbar vessels, but also the presence or absence of vascularization of LG neoplasms. A comprehensive ultrasound examination, including B-mode, color Doppler imaging, and echodensitometry, is becoming a necessary diagnostic method for LG diseases, allowing for optimization of patient treatment tactics and, when planning surgical intervention, determining the size and structure of the pathological lesion. However, questions about the standard LG sizes in individuals of different age groups and their changes in various systemic diseases and pathologies of the visual organ remain controversial. Further study of the comparability of LG measurement results by various visualization methods is required.

The review summarizes current data on the impact of COVID-19 and vaccination against it on the reactivation of human herpes viruses (HHV) and the associated development of herpetic eye diseases. A cumulative assessment of the reactivation frequency of distinct HHVs in patients with COVID-19 is presented and it shows that many COVID-19 clinical manifestations can be caused by reactivation of different HHVs. The development of herpetic acute retinal necrosis (ARN) and keratitis is described, confirmed by the presence of one of the HHVs genome in intraocular fluids, corneal cells and by the effectiveness of antiherpetic drugs (valaciclovir, famciclovir). HHV eye diseases can occur during different periods of COVID-19: acute period, recovery stage, long-term period (chronic COVID-19). Systemic pathology, history of ophthalmoherpes, corticosteroids and immunomodulatory drugs intake contribute to the reactivation of HHV and the development of herpetic eye diseases against the background of coronavirus infection. Eye complications have been reported with different types of COVID-19 vaccines. Although eye diseases are recorded much less frequently than complications of other localizations, if incorrectly diagnosed they can lead to severe functional outcomes. Most often, eye pathology in vaccinated people (ARN, keratitis, relapses of herpetic keratitis) is caused by the varicellazoster virus, although other HHVs were also detected. Although the issue of continuing vaccination after a reaction to one of the vaccine doses is controversial, the presence of side effects requires a careful assessment of all the indications and contraindications for a particular person. At the moment, most authors believe that HHV reactivation with the uprise of herpetic eye disease in vaccinated individuals is rare, and that cause-and-effect relationship with vaccine introduction needs to be confirmed. Further multicenter studies involving control groups of unvaccinated individuals are needed to comparatively assess the effectiveness and safety of commercially available vaccines.

This review is devoted to Sharp syndrome, which is an autoimmune disease of connective tissue with mixed signs of several pathologies at once (systemic scleroderma, systemic lupus erythematosus, rheumatoid arthritis, dermatoor poliomyositis). This causes clinical diversity of the clinical picture, so the diagnosis of patients with Sharp syndrome, especially in the early stages of the disease, is a difficult task for clinical practice. In approximately more than half of the cases, over time, transformation into one or another specific nosological form is possible. Eye damage is diagnosed in about a third of patients and is usually an indicator of disease activity. In this case, ophthalmologic manifestations differ and range from relatively “harmless” dry keratoconjunctivitis (which is most often recorded in all diseases included in this syndrome) and episcleritis to severe scleritis and uveitis (from iridocyclitis to panuveitis), as well as retinovasculitis, leading to severe visual impairment. Treatment of Sharp syndrome is reduced to the use of non-steroidal anti-inflammatory drugs and corticosteroids, including pulse therapy, and then basic antirheumatic drugs (immunosuppressants, etc.).

Glaucoma surgery is currently the most effective method of intraocular pressure reducing. However, the wound healing surgical area processes prevent the intraocular fluid outflow, that reduce the long-term effectiveness of the surgery. A highly effective method of preventing scarring is the use of cytostatics, however, the lack of official indications and significant side effects limit it’s use. Currently, there are more than three dozen different methods of intraand postoperative antiscar therapy, including cytostatic, anti-inflammatory, anti-angiogenic and anti-neoplastic drugs, as well as the use of β-radiation and cross-linking.

The review is devoted to the changes in tear composition in the most widespread retinal disorders: diabetic retinopathy, age macular degeneration, retinopathy of prematurity, acute blood circulation disorders, vitreoretinal pathology and also in the experimental transplantation of induced pluripotent stem cells in the model of retinal pigment epithelium dystrophy. Despite the fact that retina and tear fluid are not in touch, there is a connection between the retinal state and tear fluid metabolism due to the common regulatory pathways. Tear composition display the local physiological changes in the eye even more than blood one. Correlation between concentration of certain metabolites in tears but not in blood and stage of the pathological process in retina was revealed. The review represents data about changes of a number of metabolites playing the key role in pathogenesis of retinal diseases — factors participating in the inflammation, angiogenesis, apoptosis, hemostasis, oxidative stress. The connection between these changes in tear composition and progress of the diseases are specially highlighted because it can be used for the early diagnostics and prediction of complications that is critical for the development of optimal therapeutic strategy. Tear fluid is recently often regarded as a body fluid used for the liquid biopsy that serves for the non-invasive investigation of pathological process. Easy and non-invasive way of tear fluid collection is one more preference of the method. Progress in the detection technology that allows using of very small samples makes it possible to introduce tear fluid analysis for biomarkers to the clinical practice.

The article is dedicated to the 100th anniversary of the famous Russian ophthalmologist Skald L. Shapovalov, his life path and main scientific achievements.