Purpose: to design a method of active drying ofa fragment of internal limiting membrane (ILM) to achieve its strong adhesion to the retina in the surgical treatment of idiopathic macular hole (MH). Material and methods.The study included 10 patients (10 eyes) with large idiopathic MH. The best corrected visual acuity ranged from 0.03 to 0.1. All patients underwent active drying of inverted ILM fragment during MH surgical treatment by additional air supply through a long blunt cannula. The follow-up was up to 3 months after surgery. Results. The inverted ILM fragment retained a stable position without displacement or deformation, and had dense adhesion to the retina in all cases during the follow-up. According to SOCT, improvement of the anatomical condition of the retina in the foveal area was achieved in all patients; the closure of the MH with the preservation of the defect at the level of the ellipsoid zone of the photoreceptors of the retina was noted. Final visual acuity was from 0.2 to 0.4 (0.26±0.08 in average). Central sensitivity increased to 22.36 ± 2.29 dB, total sensitivity rose to 23.7 ± 1.43 dB. Absolute scotoma was found to disappear in the center of the fovea. Conclusions. Further investigations on larger clinical material are necessary for a reliable assessment of the effectiveness of the method. For citations: Belyy Yu.A., Tereschenko A.V., Trifanenkova I.G., Shkvorchenko D.O., Shilov N.M. The use of active intraocular drying in macular holessurgery. Russian ophthalmological journal. 2017; 10 (3): 6-12. doi: 10.21516/2072-0076-2017-10-3-6-12 (in Russian)

Purpose: to study the state of the musculoskeletal system of visually impaired schoolchildren using a topographic system TODP and analyze the prevalence of spine conditions for different ophthalmic pathologies. Material and methods. 188 visually impaired high school students and 60 students with high visual acuity (the control group) were tested using computer optic topography COMOT and the TODP topographic system. Results. The most significant conditions of the musculoskeletal system, including scoliosis, kyphosis, hyperlordosis, torsion, flatfoot, deformities of the lower extremities and the thorax were diagnosed in students with postsurgical aphakia (artiphakia) after congenital cataract extraction, with retinopathy of prematurity, and with high degenerative myopia. Pelvis tilt is most often observed in students with monocular vision. Conclusion. The need for an integrated approach to the rehabilitation of visually disabled children was confirmed. Regular orthopedic checkup of the musculoskeletal system of visually impaired children and adolescents is recommended. Preventive measures should be taken to avoid negative consequences of posture and spine deformations for internal organs and systems, which aggravate the disability // Russian ophthalmological journal. 2017; 10 (3): 13-21. doi: 10.21516/2072-0076-2017-10-3-13-21 (in Russian). For citations: Egorova T.S., Smirnova T.S. Interrelation of ophthalmic pathology with the condition of the musculoskeletal system of visually impaired schoolchildren. Russian ophthalmological journal. 2017; 10 (3): 13-21. doi: 10.21516/2072-0076-2017-10-3-13-21 (in Russian).

OCT angiography, an innovative noninvasive technique, allows a comprehensive assessment of eye vessels, separately for the choroidal and the retinal vasculature. Purpose: to assess microcirculation changes in the macular and peripapillary areas of the retina in retinitis pigmentosa (RP) by OCT angiography in comparison with electrogenesis parameters of the macular area of the retina and the cone system. Material and methods. The results of microcirculation studies of the fovea and the optic disk were analyzed for 14 patients with RP aged 5 to 76 (mean age 26.9 ± 17.6 years). OCT angiography was performed with Optovue RX Avanti (Optovue, USA). Рarafoveal vessel density, blood flow index, blood flow area, the size of the foveal avascular zone (FAZ) in the superficial and deep capillary plexuses and the flow area in retinal peripapillary capillaries (RPC) were assessed. All patients were tested by electroretinography using the MBN electroretinograph (Russia), including the general electroretingram (ERG), the maximal ERG, 30 Hz flicker ERG, and the macular ERG (MERG). Results. Blood flow deficit in superficial and deep capillary plexuses and in peripapillary capillaries (decreased parafoveal vessel density, vascular index, flow area) was associated with the reduction of a- and b-wave amplitudes of MERG and the increase of the implicit time. The enlargement of FAZ found in the deep capillary plexus (DCP) (p < 0.0001).and the normal size of FAZ in superficial capillary plexus (SCP) may be due to the difference in their structures. Conclusion. The blood flow deficit, which is more pronounced in DCP than in SCP in the macula of RP patients, is associated with the reduction of a- and b-wave amplitudes of MERG and the increase of the implicit time Russian ophthalmological journal. 2017; 10 (3): 22-28. doi: 10.21516/2072-0076-2017-10-3-22-28 // (in Russian). For citations: Zolnikova I.V., Levina D.V., Okhotsimskaya T.D., et al. Electroretinography and OCT angiography of the retina and optic nerve in retinitis pigmentosa. Russian ophthalmological journal. 2017; 10 (3): 22-28. doi: 10.21516/2072-0076-2017-10-3-22-28 (in Russian).

Purpose: to compare subtle changes in retinal and optic disk morphology and microcirculation and the functional activity of visual channels in patients with multiple sclerosis (MS) and optical neuritis (ON) in the medical history. Material and methods: 19 patients with remitting MS (duration of about four years) and ON developed about six months ago were tested by standard neurologic and ophthalmologic techniques, optical coherent tomography (OCT) with the angio OCT (RTVue XR 100 Avanti) protocol. The pattern ERG (PERG), as well as visual evoked potentials (VEP), on the reversing black/ white, pure luminance (black/yellow) and chromatic (red/green and blue/yellow) chess stimuli were recorded (RETI-port/ scan, Roland Consult, Germany). Results: At the level of superficial capillary plexus, the density and the area of vessels were reduced in the parafoveal zone, and the blood flow index dropped significantly (to 82.6% against the control). No statistically significant changes of blood flow were found in the peripapillary zone. The peak latency of P50 in the PERG responses to all stimuli showed a statistically significant reduction. The peak latency of N95 was delayed by an average of 10 % as compared to the controls. The amplitude of PERG N95 was moderately reduced for stimuli of all sizes. The elongation of the culmination time for the peak P100 was shown to be significant only in the VEP responses to blue/yellow patterns with angular sizes of 16° and 0.3°. A decrease in the thickness of the ganglion cells (GCC) complex correlated highly with reduced microcirculation in the superficial capillary plexus. Conclusion: Early changes of the retinal function were documented in patients with recent MS and ON history with almost equal involvement of the retinal ganglion cells of the parvo-, mango- and koniocellular systems into the pathological process. For the first time, we established direct correlation between the parameters of microcirculation and morphometry of the inner retina. Clinical significance of the simultaneous detection in MS patients of the delay of P100 latency in the VEP and reduction of the thickness of the SCC and the retinal nerve fiber layer was shown. For citations: Lantukh E.P., Zueva M.V., Tsapenko I.V., et al. Microcirculatory and functional changes in the retina and visual channels in multiple sclerosis. Russian ophthalmological journal. 2017; 10 (3): 29-41. doi: 10.21516/2072-0076-2017-10-3-29-41 (in Russian).

Purpose: To study primary and recurrent glaucoma-induced disability in senior working-age people in the Altai Territory over the period of 2004-2013. Material and methods. The data of the Bureau of medico-social examination for the period have been analyzed to determine the main parameters of disability: the intensive (primary disability prevalence per 10 thousand individuals) and the extensive markers (percentage distribution of primary disability causes). Results. Over the researched period, the number of Altai territory individuals registered as invalids for the first time due to diseases of the eye and adnexa decreased by 2.14 times, while the number of people classified as recurrent invalids showed a 1.4 - fold increase. In the nosological structure of primary disability due to diseases of the eye and adnexa, glaucoma consistently claimed rank 1, while in recurrent disability glaucoma rose from rank 3 to rank 1, and its share in the structure of repeated disability causes increased by 2.1 times. The cohort of primary and recurrent glaucoma-induced invalids mainly includes people older than the official working age, who claimed 87.4 % and 61.6 % in primary and recurrent disability, respectively. The proportion of invalids of group I (41.3 and 40.2 %) and group II (37.7 and 38.2 %), respectively for primary and recurrent disability, was significantly higher than the proportion of III group invalids (21 and 21.6 %, respectively). Conclusion. The dynamics and structure of primary and recurrent glaucoma-induced disability in senior working-age population showed that the tactics of prevention, concrete preventive measures, and rehabilitation procedures for glaucoma patients need to be developed. For citations: Makogon S.I., Makogon A.S. Primary and recurrent glaucoma-induced disability in senior workingage population in the Altai territory. Russian ophthalmological journal. 2017; 10 (3): 42-48. doi: 10.21516/2072-0076-2017-10-3-42-48 (in Russian).

Purpose: to evaluate the thickness of corneal epithelium after orthokeratological (OK) correction with the help of SDOCT. Material and methods: 18 patients (36 eyes) averagely aged 12.11 ± 1.68 with myopia of -3.21 ± 0.94 D and axial length of 24.47 ± 0.7 mm were examined. All patients were checked for corneal epithelial thickness (ET) with the help of SD-OCT Avanti RTVueXR (Optovue Inc., Fremont, CA, USA), which created maps of 6 mm in diameter before OK correction with lenses ESA-DL (Dr. Lens Technology, Russia) and 36.44 ± 5.81 days after it. A corneal ET map was divided into 17 sectors with average values indicated, and 3 zones (the central zone of 2 mm, the paracentral zone from 2 to 5 mm, and the mid-peripheral zone from 5 to 6 mm). We calculated the maximum (Max) and the minimum (Min) values of ET, the difference between them (Max Min) in the 5 mm zone, and standard deviation of values in the 5 mm zone (Std Dev). Results. The corneal ET showed no difference among the sectors of the 6-mm map (p > 0.05) before OK lenses were worn. The ET in the central zone was 53.1 ± 1.68 μm. The ET in the central zone decreased by 16.6 % from the initial value after 36.44 ± 5.81 days of OK correction, with a single sector (S) showing a statistically significant difference in the paracentral zone. In the mid-peripheral zone, the ET increased by 14.1 % from the reference. Max and Min ET, and Max-Min Std Dev in the 5-mm zone differed significantly after OK correction (p < 0.05). Conclusion. After OK correction, the ET significantly decreases in the central zone and increases in the mid-peripheral zone. These changes account for the flattening of the anterior corneal surface and contribute to the refractive effect of OK lenses. For citations: Milash S.V., Tarutta E.P. Changes of corneal epithelial thickness before and after OK-correction according to SD-OCT. Russian ophthalmological journal. 2017; 10 (3): 49-54. doi: 10.21516/2072-0076-2017-10-3-49-54 (in Russian).

Purpose: to study the impact of human herpes viruses (HHV) on the development of infectious corneal ulcers (CU). Material and methods. 43 patients aged 21 to 77 with suspected corneal ulcers of bacterial etiology were examined. Based on the history and ophthalmological examination, the patients were divided into 3 groups: group 1 of 26 patients with herpetic ulcers (HU), group 2 of 13 patients with secondary bacterial ulcers (SBU), and group 3 of 4 patients with primary bacterial ulcers (PBU). Blood (43 samples) and corneal scrapings (29 samples) were examined by nested polymerase chain reaction (PCR) for the presence of DNA of various HHV, including herpes simplex virus (HSV) 1, 2, Epstein - Barr virus (EBV), HHV-6, and HHV-7. Results. HHV was detected in 41.6-53 % of the corneas and in 33.3-50 % of blood samples, depending on the patient group. Clinical patients with the DNA of HHV identified in their cornea had torpid CUs and showed no epithelization following the suppressed purulent process. The addition of antiherpetic drugs resulted in complete epithelialization of the cornea within 3-5 days. Conclusion.The frequent representation of HHV-6 and EBV DNA and less frequently detected HSV DNA in the corneal scrapings indicate the possible involvement of HHV in the etiopathogenesis of SBU. The effectiveness of complex antiherpetic drug therapy supports this conclusion. For citations: Neroev V.V., Slepova O.S., Kovaleva L.A., Krichevskaya G.I. Optimizing etiological diagnostics and improving the efficiency of treating centralized infectious corneal ulcers. Russian ophthalmological journal. 2017; 10 (3): 56-61. doi: 10.21516/2072-0076-2017-10-3-56-61 (in Russian).

Pseudoexfoliation syndrome (PEX) is a widespread generalized disease. While changes of diverse structures of the eyeball in PEX are studied in detail, the situation is different with the state of ocular surface tissues. Purpose:to detect possible causes of damage of ocular surface tissues in patients with PEX. Material and methods. 130 patients (260 eyes) were divided into two groups: the main group of 66 patients (132 eyes) aged 75.95 ± 1.62 years with PEX syndrome and the control group of 64 patients (128 eyes)aged 73.78 ± 2.12 years without PEX. We evaluated the condition of meibomian glands, the tone of lower eyelids, tear film break-up time, the staining grade of conjunctiva and cornea and the extent of conjunctivochalasis, conducting Schirmer’s test-II. Results.Meibomian gland dysfunction was significantly more expressed in patients with PEX. Signs of atonic changes of lower lids were found to be more common in patients with PEX. PEX also showed a statistically significant reduction of tear film break-up time and a pronounced damage of conjunctival surface. Conclusion. PEX is not only accompanied by damaged tissues of the ocular surface but also by damaged adnexa and eye lide edges. The obtained data reveal a kind of vicious cycle consisting of meibomian gland dysfunction, atonic lower eyelid malposition, and damaged tissues of the ocular surface. For citations: Potemkin V.V., Ageeva E.V. Causes of ocular surface tissue lesions in patients with pseudoexfoliation syndrome. Russian ophthalmological journal. 2017; 10 (3): 62-68. doi: 10.21516/2072-0076-2017-10-3-62-68 (in Russian).

Purpose: to evaluate the effectiveness of transpupillary thermotherapy (TTT) of small calcified retinoblastomas (SR) having various calcification degrees. Material and methods. The results of treatment of 111 children (92 eyes, 198 tumors) with small calcified retinoblastomas by TTT were analyzed. All tumor foci were divided into 3 groups: Group 1, with tumor size of 1.0 mm or less with a low degree of calcification in the form of small specks of single grains (69 tumors); group 2, with tumor sizes between 1.1 and 2.0 mm and calcination degrees varying from small singular inclusions to a third of tumor volume (61 tumors), and group 3, with tumor sizes between 2.1 and 3.0 with calcifications claiming from one third to three fourths of tumor volume (68 tumors). Results. TTT proved effective after one application in 82.6 % of Group 1 cases, 70.5 % of Group 2 cases, and in 38.2 % of Group 3 cases. The presence of calcinates in the tumor stroma is no contraindication for TTT. Conclusion. TTT used in combined eye preserving RB treatment destroys in most cases calcified tumor foci, and allows for an extended list of indications to eye preserving treatment, which enables the preservation of the eye not only as a cosmetic but as a functional organ. For citations: Saakyan S.V., Tatskov R.A., Myakoshina E.B., et al. Transpupillary thermotherapy efficiency in the combined treatment of small calcified retinoblastoma. Russian ophthalmological journal. 2017; 10 (3): 71-77. doi: 10.21516/2072-0076-2017-10-3-71-77 (in Russian).

Purpose: a comparative study of the effect of cycloplegia on wavefront aberration in children with myopia and hyperopia. Material and methods. The study involved 20 patients (39 eyes) with myopic refraction (averagely -5.2 ± 1,5 D) and 26 patients (52 eyes) with hyperopic refraction (averagely +3.1 ± 1.15 D), aged 5 to 17 (mean age 11.6 ± 0.6 years). All patients underwent wavefront aberrometry in a darkened room before and after a cycloplegic drug administration (1 % cyclopentolate dehydrochloride 2 times with an interval of 10 minutes, aberrometry 30 minutes after the first instillation) using the aberrometer OPD-Scan III, Nidek. Aberrations of the lower and higher orders were analyzed with a pupil 3 mm wide, both without and under cycloplegia (in the latter case, a 3 mm band was chosen). Total aberrations (RMS) were studied. Zernike coefficients were used to calculate the standard deviation of total higher order aberrations (RMS HOAs), the vertical and the horizontal tilt (C1-tilt1, C2-tilt2), the vertical and horizontal trefoil (C5-trefoil 6, C8-trefoil 9), the vertical and horizontal coma (C6-coma7, C7-coma8), and spherical aberration (S4 + S8 + S12). Results. Both myopia and hyperopia treated with cycloplegia showed a statistically insignificant increasing trend of higher order aberrations and spherical aberration. Under natural conditions, the levels of tilt1 aberration, horizontal trefoil and coma7 proved significantly higher in myopia than in hyperopia, while coma8 and tilt2 turned out to be significantly lower than in hyperopia. In myopic eyes, no significant changes were found in any of the examined HOAs after cycloplegiaas compared to the initial state. In contrast, significant changes were found in hyperopia: an increase in horizontal trefoil and a decrease in horizontal coma. An insignificant trend towards an increase in Tilt1 and coma7 and toward a reduction in the vertical trefoil and tilt2 was revaeled. Conclusions. Under natural conditions, a 3-mm wide pupil shows no statistically significant difference between the total level of aberrations of the optical system of the myopic eye and hyperopic eyes in children, while the the wavefront structures in these groups demonstrate essential differences. The differences revealed in the wavefront structure and its dynamics under cycloplegia may indicate differences in the accommodation apparatus, in particular, the ciliary muscles and ligaments of the lens for myopia and hyperopia. For citations: Tarutta E.P., Аrutyunyan S.G., Smirnova T.S. Wavefront aberrations in children with myopia and hyperopia before and after cycloplegia. Russian ophthalmological journal. 2017; 10 (3): 78-83. doi: 10.21516/2072-0076-2017-10-3-78-83 (in Russian).

Purpose: development of a modified eye evisceration technique using radio wave surgery and evaluation of its effectiveness. Material and methods. The results of treatment of 383 patients were analyzed. The majority were men aged 19 to 55 (62.7 %) after eye removal. Of the treated patients, 328 (85.6 %) were operated due to the trauma. Surgery techniques included enucleation with stump plastics (131 patients, comparison group I), evisceration with sclera posterior pole resection, neurectomy and stump plastics (83 patients, comparison group II) and a modified method involving radio wave surgery and locomotor stump formation (169 patients, main group). For the orbital implant, carbon felt (Carbotextim) or Polytetrafluoroethylene (Teflon) were used. The patients were followed up for 6 months to 3 years. Results. In all cases, the results of surgical treatment and subsequent eye prosthetics were positive: their were traced in 344 patients (89.7 %). The best functional and cosmetic results assessed according to several features (retraction of the prosthesis and the upper lid into the orbit, stump and prosthesis mobility) were achieved after evisceration with stump plastics (in the main group and comparison group II).Conclusion. Using the above technique in subatrophy and enhancement of safety of the modified technique in posttraumatic uveitis validate the extension of indication to evisceration. For citations: Filatova I.A., Mohammad I.M., Shemetov S.A. Modified eyeball evisceration surgery using radio wave surgery technique. Russian ophthalmological journal. 2017; 10 (3): 84 92. doi: 10.21516/2072-0076-2017-10-3-84-92 (in Russian).

Purpose: to study the impact of crosslinking (CL) on the healing of corneal ulcers of various etiologies. Materials and methods. Treatment results of 15 patients with corneal and transplant ulcers by CL and its combination with other surgical interventions were analyzed. Results. For the first time three options of combined treatment of corneal ulcers were proposed: 1) CL as an independent method; 2) CL combined with transplantation of amniotic membrane (ТАМ) and temporary tarsorrhaphy; 3) corneal grafting combined with CL. The main diagnostic technique of treatment result evaluation was OCT of the anterior segment of the eye. Results. CL was found to contribute to the cleaning of the bottom and the edges of the ulcer surface, to promote the resorption of the hypopyon and the edema, leads to rapid healing of the ulcer and the reduction of the corneal syndrome and increases visual acuity. Conclusion. The obtained data indicate the need for further study of the impact of CL on the healing process of corneal and transplant ulcers. For citations: Chentsova E.V., Verigo E.N., Makarov P.V., Khazamova A.I. Crosslinking in the complex treatment of corneal ulceration and corneal grafting. Russian ophthalmological journal. 2017; 10 (3): 93-100. doi: 10.21516/2072-0076-2017-10-3-93-100 (in Russian).

Purpose: to study the results of toric intraocular correction following a surgical treatment of cataract in a 69-year-old patient with the 2nd stage of keratoconus by Amsler-Krumeich classification with intrastromal corneal segments implanted. Methods. During the first visit, the patient had 0.1 best corrected visual acuity (BCVA). The choice of an intraocular lens Tecnis Toric IOL (Abbott, USA) and the optimization of the planned operation was performed on the website of the IOL manufacturer according to the data obtained by partial coherence optical biometry IOL-Master (Carl Zeiss, Germany), dual Scheimpflug Placido keratotopography on the Analyzer of anterior eye segment Galilei G6 (Ziemer, Switzerland), and keratotopography on Magellan Mapper (Nidek, Japan).Results. 6 months after the implantation of intrastromal corneal ring segments, BCVA was 0.2. On the next day after cataract phacoemulsification with implantation of a toric IOL, BCVA was 0.4. 2 years after the implantation of intrastromal corneal segments and phacoemulsification with implantation of a toric IOL, the patient's BCVA was 0.7. Conclusions. We obtained high refractive outcome of a combined staged use of intrastromal corneal segments and correction of aphakiaby a toric IOL in a patient with stable stage 2 keratoconus. A two-year follow-up showed that BCVA and the position of the toric IOL axis remained stable after surgery. For citations: Oganesyan O.G., Romanova L.I., Milash S.V., Penkina A.V. Toric intraocular correction following cataract extraction in a patient with keratoconus after implantation of intrastromal corneal ring segments: a clinical case. Russian ophthalmological journal. 2017; 10 (3): 102-106. doi: 10.21516/2072-0076-2017-10-3-102-106 (in Russian).

Drug allergy is one of the most common issues not only in ophthalmology, but in the general medicine. Drug-induced conjunctivitis is an inflammatory reaction of the conjunctiva, allergic or toxic, caused by the use of medicines. The frequency and severity of drug-induced conjunctivitis continuously increase as the arsenal of biologically active drugs increases. The purpose of the paper is to compare the efficacy of eye drops Opatanol (0.1 % olopatadine) and Vizallergol (0.2 % olopatadine) in the therapy of drug conjunctivitis. Materials and methods. Clinical observation involved 42 patients (26 women and 16 men) with drug conjunctivitis aged 28 to 56, which were divided into two groups. Group 1 (22 patients) received 2 drops of Opatanol twice a day, whill group 2 (20 patients) received 2 drops of Vizallergol once a day. The clinical observation included careful collection of history data, visometry andbiomicroscopy with the assessment of the condition of the eyelids and conjunctiva, taking into account the follicular reaction on a 3-point scale. Results. In the process of treatment, subjective sensations (itching, burning, discomfort) were found to gradually reduce in both clinical groups. The average duration of treatment in group 1 was 11 ± 0.1 days, in group 2 - 9 ± 0.3 days. Conclusion. The therapeutic effect of Vizallergol was somewhat higher than that of Opatanol, which is explained by a higher concentration of the main active substance, olopatadine. For citations: Jani E.V., Pozdnyakova V.V., Seliverstova K.E. New opportunities of the therapy of medicinalophthalmic allergies. Russian ophthalmological journal. 2017; 10 (3): 108-112. doi: 10.21516/2072-0076-2017-10-3-108-112 (in Russian).