Purpose. To compare the results of traditional and modified fistulizing surgery for secondary refractory glaucoma. Material and methods. 39 patients (39 eyes) aged 25 to 79 (24 and 15 women) who received the surgery were divided into 2 groups: 17 patients of the control group underwent traditional trabeculectomy or deep sclerectomy while 22 patients of the main group received tunnel trabeculectomy with iridocycloretraction. 27 patients were followed up for up to 2 years. Results. No significant difference between the compared groups was found with regard to the incidence of early postoperative complications (hyphema, ciliochoroidal detachment). After surgery, which in some cases was supplemented by the course of additional antihypertensive therapy, IOP returned to normal in 77.8% of cases. For neovascular glaucoma, the results were worse both after modified and traditional trabeculectomy procedures (40.0%). The best sustained hypotensive and functional effect was achieved after tunnel trabeculectomy with iridocycloretraction (in 68.8% of cases), while after traditional trabeculectomy the effect was lower (45.5%). Conclusions. The obtained results show that the proposed modified operation may be considered, in some cases, as an alternative to drainage surgery in patients with refractory secondary glaucoma. Neovascular glaucoma is a contraindication to tunnel trabeculectomy with iridocycloretraction. Yet, modified trabeculectomy may be recommended also to patients with neovascular glaucoma, on condition that the procedure is preceded by effective surgery which eliminates or reduces neovascularization of the iris and the anterior chamber angle // Russian Ophthalmological Journal, 2016; 3: 5-11. doi: 10.21516/2072-0076-2016-9-3-5-11.

Purpose: To compare treatment areas and navigated macular laser photocoagulation (MLP) plans suggested by retro-mode scanning laser ophthalmoscopy (RM-SLO) image versus optical coherence tomography (OCT) retinal thickness map. Methods. 45 eyes of patients aged 63,1±10,2 years with diabetic or retinal vein occlusion-related ME were subjected to navigated MLP on the basis of OCT maps and RM-SLO images imported to NAVILAS navigated laser system. The plans for coagulant quantity based on OCT and RM-SLO images and the areas of retinal edema revealed by each method were compared. Results. The average number of laser spots using RM-SLO and OCT template was 171,2 ± 75,1 vs 125,9 ± 59,2 respectively, p = 0,002. The average area of edema on RM-SLO image was larger than that on OCT maps (14,9 ± 4,1 мм2 vs10,2 ± 2,9 mm2, p = 0,007) because of a larger scanning area. Conclusion. The RM SLO image can be used to guide MLP. The treatment areas suggested by RM-SLO-guided MLP plans for ME were shown to be larger than those suggested by OCT-guided plans // Russian Ophthalmological Journal, 2016; 3: 12-7. doi: 10.21516/2072-0076-2016-9-3-12-17

Purpose: To develop a program of dosage and anatomical planning of proton therapy on the basis of a 3-D model of the eye presenting the eye structure, risk areas, and the tumor. Results: Dose field calculations are made for the spherical, ellipsoidal and ovoidal model of the eyeball. The effects of the wrong choice of the model on these calculation for the tumor and the eye structures are shown. Conclusions: A wrong presentation of the volume geometry of the eye results in errors in determining the dose absorbed in critical structures. It is shown that individual density values for each structure should not be replaced by averaged values when calculating the radiological equivalent (water-equivalent) thickness, as the averaging in calculating dose distributions may lead to an underestimation of the dose absorbed in critical structures and to an incorrect matching of the target and the dose field // Russian Ophthalmological Journal, 2016; 3: 19-25. doi: 10.21516/2072-0076-2016-9-3-19-25.

Purpose: To investigate the state of blood flow in eye vessels and brachiocephalic arteries (BCA) in patients with arterial hypertension (AH) of stages 1 and 2 and subclinical atherosclerosis (SA) using modern methods of vessel imaging. Material and methods. Doppler ultrasound methods of investigation of retrobulbar vessels and caliber measurements of eye fundus vessels were used to examine 115 patients (230 eyes) aged 40-60 (averagely 48.7 ± 7.3 yrs) with mild hypertension and subclinical atherosclerosis, for whom the parameters of choroidal and retinal circulation were determined. Results.The maximum systolic velocity of blood flow in retrobulbar vessels were found to agree with the age norm in SA while the index of peripheral vascular resistance parameters in the system of retinal and choroidal circulation exceeds the norm. In stages 1 and 2 of AH, we detected increased peripheral resistance index in the short posterior ciliary arteries and reduced caliber of retinal arteries with no significant change of retinal venular caliber. In patients with combined pathology, the changes were more pronounced. Conclusions. Ultrasound duplex scanning of BCA helps diagnose early signs of the atherosclerotic process and vascular deformations (hypertonic macroangiopathy), which testify to the need for ocular blood flow monitoring in patients with stages 1 and 2 of AH and SA // Russian Ophthalmological Journal, 2016; 3: 26-33. doi: 10.21516/2072-0076-2016-9-3-25-33.

To assess the blood supply to the peripapillary area in patients with primary open-angle glaucoma (POAG) using optical coherence tomography with the function of amplitude decorrelation angiography (OCT-A). Material and Methods. 65 eyes of POAG patients (the main group) and 22 eyes of age-matched healthy subjects (the control group) were examined. Spectral OCT (SD-OCT) technique with AngioVue OCT function was used to measure the average value of amplitude decorrelation (Peripapillary Flow Index), peripapillary vessel density, the parameters of the ganglion cell complex (GCC), including the focal loss volume (FLV) and the global loss volume (GLV), and the retinal nerve fiber layer (RNFL). Results. We revealed that blood flow reduction in the peripapillary retina, detected by OCT-A, precedes not only the functional but also the structural loss, determined by OCT and SAP. Conclusions. The new noninvasive technique for the examination of retinal blood flow, OCT-A, determines the reduction of hemoperfusion in peripapillary retina even at an early POAG stage and can serve as an important diagnostic method for early glaucoma detection // Russian Ophthalmological Journal, 2016; 3: 34-41. doi: 10.21516/2072-0076-2016-9-3-34-41.

Endocrine ophthalmopathy patients constitute a group of risk for the development of secondary open angle glaucoma (SOAG). Disrupted blood circulation in the main vessels of the eye and the orbit is a mechanism triggering eye hypertension. Purpose: To assess quantitatively the eye blood flow in patients with SOAG developed after endocrine ophthalmopathy. Material and Methods. 48 eyes of SOAG patients averagely aged 42±2.3 years were examined. SOAG, combined with endocrine ophthalmopathy, was characterized by normal eye pressure (63%) and hypertension (37%). Results. The depth and topography of the area with insufficient blood filling may be considered as a key factor that determines the form of SOAG in endocrine ophthalmopathy. Reduced diastole duration, even under longer systole, was found to aggravate ischemia and lead to disturbed blood distribution in the choroid, involving choroid capillaries directly supplying blood to external layers of retina. Conclusions. The reduction of systolic and diastolic phases of the heart cycle leads to grave deficiency of blood filling with predominate ischemia of the anterior segment of the eye, the ciliary body, edema of the trabecula and disturbed intraocular fluid outflow, resulting in the development of ophthalmic hypertension // Russian Ophthalmological Journal, 2016; 3: 43-9. doi: 10.21516/2072-0076-2016-9-3-43-49.

Purpose: to compare the effect of rigid gas permeable contact lenses (RCL) in the improvement of visual functions vs. spectacle correction in scar-induced astigmatism of the cornea and concomitant posttraumatic conditions. Material and methods. A total of 147 patients (147 eyes) aged from 3 to 67 yrs with scar-deformed cornea as a result of injuries and diseases of the eye were examined. All patients underwent a comprehensive clinical and instrumental ophthalmologic examination. RCL were prescribed to 121 patients (82%). Results. All patients wearing RCL showed an increased visual acuity as compared with the maximum spectacle correction. The study was also used to assess a newly proposed material, Hydro GP, which combines the optical properties of RCL and the comfort of soft contact lenses. The use of RCL made of this material ensures the highest possible visual acuity while reducing the incidence of complications associated with lens wearing, as well as raises the level of comfort. Conclusions. RCL are a more effective means of scar-induced astigmatism correction than the spectacles. The former contribute to the recovery and the improvement of monocular and binocular visual functions // Russian Ophthalmological Journal, 2016; 3: 50-53. doi: 10.21516/2072-0076-2016-9-3-50-53.

Purpose: to compare the data of autokeratorefractometry (AKR) and keratotopography (KT) of patients with eye trauma consequences and cicatricial corneal astigmatism. Material and Methods. 75 patients (75 eyes) aged 18 to 70 (averagely 36.9±13.9 years) with this pathology were examined for the dependence of astigmatism value on the distance between the nearest point of the scar and the optical center of the cornea. The cornea was divided into 3 zones: the central zone covering the area within a radius of 1.5 mm from the optical center, the paracentral zone with the radius between 1.6 and 3.0 mm from the optical center, and the peripheral zone starting at 3.1 mm from the optical center. Results. The best corrected visual acuity (BCVA) obtained using CT (0.79±0.13) in patients with paracentral location of the non-vascularized corneal scar was higher than that of patients who received AKR correction (0.73±0.16). Conclusions. The use of CT data in this group of patients significantly increases the accuracy of BCVA measurement, which, in turn, can affect the choice of the treatment plan. In the case of vascularized scars of the cornea of any localization, CT data will not be significantly more informative then AKR data as far as subjective correction choice is concerned // Russian Ophthalmological Journal, 2016; 3: 54-9. doi: 10.21516/2072-0076-2016-9-3-61-65.

Purpose: to characterize the quality of life (QOL) of young patients with uveal melanoma (UM) after surgical treatment. Materials and methods. 23 patients with UM aged 11 to 25 (mean age 21±4,1 years, 11 females, 12 males) were surveyed on the issue. Of these, 17 people received eye-preserving treatment while 6 patients underwent enucleation. The survey, taken 9-110 months (Me=36) after treatment start, used a generic 36-Item Short-Form Health Survey (SF-36) for cancer patients. Results. The average values of QOL parameters in young UM patients exceed those of healthy people in the population in most scales of the questionnaire. The patient’s sex and treatment type had no effect on the QOL, which was found to improve after eye-preserving treatment during the first year. Statistically significant differences were obtained for scales GH (p=0,043), FF (p=0,042), VT (p=0,043) and PH (p = 0,039). Conclusions. The obtained results testify to high adaptive capacities of UM patients as regards their physical and emotional state caused by eye cancer // Russian Ophthalmological Journal, 2016; 3: 61-5 doi: 10.21516/2072-0076-2016-9-3-61-65.

Purpose. To study the effect of antioxidant resveratrol on hemodynamics and morphological changes in the ocular structure of rats with retinal ischemia-reperfusion injury. Material and Methods. The experimental study was performed on 50 Wistar rats. The animals were divided into two groups: group I (20 intact animals) and, group II (30 animals who received resveratrol per os for one month. We modeled unilateral ischemia-reperfusion of the eye by increasing IOP to the level of 110 mm Hg within 30 minutes, pumping air into the anterior chamber. Group I was further divided into subgroup IA (10 animals undergoing ischemia-reperfusion modeling of one eye and IB (control) which consisted of 10 intact rats. All animals of group II kept receiving resveratrol for 1 month and underwent the modeling of ischemia-reperfusion of the eye, whereupon the administration of reservatrol was resumed for another month. Ocular blood flow was estimated using power Doppler (PD) and pulsed-wave spectral Doppler ultrasonography before ischemia-reperfusion and 3, 7, 30 days after it. The eyeball was enucleated on the 3 rd, 7th, or 30 th day in the post-ischemic period of the experiment to enable a pathomorphological study. Results. The signs of ischemic damage of the anterior and posterior segments of the eye were reduced in rats who received resveratrol during the pre-ischemic (within 30 days) and the post-ischemic follow up period (30 days). We noted a statistically significant increase of peak systolic velocity (Vsyst), increase of end diastolic velocity (Vdiast) and decreased resistance index (RI) in the central retinal artery and short posterior ciliary arteries of rats that were treated with resveratrol as compared to the respective values found in rats with ischemia-reperfusion of the retina who were not given resveratrol. A histopathological examination revealed areas with intact retinal layers in rats who received resveratrol for a long period (1-2 months). Conclusions. An improvement of ocular blood flow and a neuroprotective effect was found in rats with ischemia-reperfusion who received resveratrol // Russian Ophthalmological Journal, 2016; 3: 66-74. doi: 10.21516/2072-0076-2016-9-3-66-74.

The paper discusses promising approaches to pathogenetic treatment of tuberculous uveitis from the standpoint of the concept of free radical oxidation of lipids and antioxidant protection. An overview of medications currently used is provided. An experiment aimed at finding promising molecules with oxidative and antioxidant activity is reported // Russian Ophthalmological Journal, 2016; 3: 75-9. doi: 10.21516/2072-0076-2016-9-3-75-79.

A clinical case of a rare and severe chronic autoimmune disease - pemphigoid scarring of the conjunctiva in a female patient aged 66 is presented. The etiological diagnosis was established only 14 months later, when serious complications, including a severe syndrome of dry eye, symblepharon and changes in the cornea manifested in a vascularized pannus. Ophthalmologists are recommended to be watchful of scarring pemphigoid in cases of persistent and severe bilateral conjunctivitis, torpid to conventional treatment or showing signs of cicatrical mucosa changes, especially in the lower arch, and combined with bullous-erosive lesions of mucosa especially in the oral cavity, epipharynx, or skin. Keywords: scarring pemphigoid, conjunctivitis, symblepharon, dry eye syndrome // Russian Ophthalmological Journal, 2016; 3: 81-4. doi: 10.21516/2072-0076-2016-9-3-81-84.

Purpose: to assess the first results of intravitreal injection of an implant of dexamethasone 0.7mg for the treatment of post-traumatic uveitis and prevention of post-traumatic eyeball subatrophy. Material and Methods: patient А., 18 years old, was admitted to the hospital with the following diagnosis: a penetrating wound of the right eyeball, post-traumatic corneal scar, post-traumatic iridocyclitis, a posttraumatic swelling cataract, hemophthalmus, local peripheral retinal detachment. The left eye was undamaged. The right eye was given two intravitreal injections, with an interval of 4 months. Results. The follow-up of the patient showed an improvement after the first intravitreal injection of the implant manifested in reduced inflammatory response of the eye, IOP increased from 8 to 11 mm Hg, elongation of the anterioposterior axis of the eyeball from 16.02 mm to 21.63 mm, practically complete hemophthalmus resorption, a significant reduction of retinal edema. After the second intravitreal injection of the implant the positive changes developed: the visual acuity increased from 0.02 to 0.04, IOP increased from 11 to 14 mm Hg, the anterioposterior axis of the eyeball elongated from 21.63 mm to 21.67 mm, hemophthalmus resorbed completely and the retinal edema reduced. Conclusion. The clinical case demonstrates the effect of intravitreally injected implant of dexamethasone 0.7 mg in arresting the inflammatory process // Russian Ophthalmological Journal, 2016; 3: 85-90. doi: 10.21516/2072-0076-2016-9-3-85-90.

Approaches to the treatment of inflammatory diseases of the eyelids are extensively discussed in literature and clinical practice. Kombinil®-Duo eye drops are widely used as a combined anti-inflammatory preparation with antibacterial effect in the topical treatment of these diseases. The effect of these eye drops on eyelid skin in combination with the moistening of the eye surface with artificial tear preparations containing no preservatives provides a significant improvement in the conjunctiva, tear production and tear film break time prameters, regardless of the etiology of the process // Russian Ophthalmological Journal, 2016; 3: 91-3. doi: 10.21516/2072-0076-2016-9-3-91-93.

We present literary data on the incidence of sympathetic ophthalmia (SO) after an open eye trauma or eye surgeries, and the incidence of preventive enucleation. The statement that SO is today a disappearing disease is a myth. Even though it is a rare disease, its incidence after an open trauma amounts to 0.46% (by the data of Russian authors), or to 0.24% in children and 0.3-0.9% in adults (by foreign data) and does not tend to drop. After cataract extraction or antiglaucomatous surgery, SO is almost nonexistent. In contrast, repeated interventions, primarily vitreoretinal surgery, constitute a risk factor of SO, so that postsurgical SO in this case is 0.06-0.12%. The topical character of SO issue is determined by the fact that, due to SO threat the surgeons often (in 4.3 to 20% of cases) resort to preventive enucleation // Russian Ophthalmological Journal, 2016; 3: 95-100. doi: 10.21516/2072-0076-2016-9-3-95-100.

Traumatic fractures of the orbit are fairly frequent injuries both in wartime and in peacetime. The purpose of the paper is to present the modern view of orbital lesions and their consequences, based on literary data and the authors’ personal experience. Surgical treatment consisting in the reconstruction of the original orbital shape and volume and in repositioning of orbital contents to their previous location is the only correct method of treating these injuries, which has to be resorted to as soon as possible. In cases of neglected fractures of orbital walls and edges, we need to refracture the bone, reposition and fix the broken orbital fragments, and then, concomitantly, reconstruct the orbital shape and volume as well as reposition the orbital contents in their original location. In patients with neglected orbital fractures, the results of surgical treatment (correction of eye position, enophthalmos, and double vision) are considerably poorer than those achieved after surgical treatment of fresh injuries. In reconstructing the orbital wall, autologous transplants are used (the cranial bone, the ilium, the bone of the front wall of the maxillary sinus, constal cartilage) as well as a variety of alloplastic materials // Russian Ophthalmological Journal, 2016; 3: 101-9. doi: 10.21516/2072-0076-2016-9-3-101-109.