Purpose: to set out morphofunctional differences in the ophthalmic status between suspected glaucoma (SG) and the initial stage of primary open angle glaucoma (POAG), determine the values of interocular asymmetry of the analyzed parameters of fellow eyes and create a model able to distinguish, with high accuracy, between healthy subjects, SG patients and POAG patients relying on a few independent parameters. Material and methods. A multicenter study performed between July and November, 2016, by 34 research and clinical facilities of four countries (Russia, Belarus, Uzbekistan, and Moldova) involved 501 patients (824 eyes), of which 362 (72 %) were female and 139 (28 %) male. The main analyzed group consisted of 128 eyes with SG, 228 eyes with early stage POAG and 145 eyes of healthy subjects (the control group with comparable sex and age distribution and no history of glaucoma). The fellow-eye symmetry analysis group involved 190 eyes with SG, 336 eyes with early stage POAG and 220 eyes of 110 subjects with no glaucoma. Results. Differences were found in the structural and functional ophthalmologic parameters in early-stage POAG, SG, and the absence of glaucoma. The precision of SG and early POAG may be increased by cumulative consideration of several clinical parameters. Conclusions. The sensitivity and specificity of the integral index of condition prognostication increases when several parameters are analyzed simultaneously, as compared to the separate analysis of constituents. For citations: Avdeev R.V., Alexandrov A.S., Arapiev M.U., et al. Suspected glaucoma and early stage glaucoma: differential diagnostic criteria. Russian ophthalmological journal. 2017; 10 (4): 5-15. doi: 10.21516/2072-0076-2017-10-4-5-15 (In Russian).

Purpose - to determine the correlation between the lens density index and ultrasound dose. Materials and methods. The experimental group of 60 patients (average age 76.4 years) with immature and mature age-related cataract were examined using lens spectrofluorometry to determine the lens density index recording, followed by cataract phacoemulsification and cumulative ultrasound dose registration. Results. A positive correlation between lens density and the total ultrasound dose was revealed. Conclusion. UV-induced spectrofluorimetry of the lens may be used as a prediction method of postoperative complications after ultrasound cataract phacoemulsification as well as basis for choosing a cataract surgery approach. For citations: Gar’kavenko V.V., Salmin V.V., Lazarenko V.I., Shapovalov K.A. Choosing the cataract surgery approach on the basis of spectrofluorometric examination of the of lens. Russian ophthalmological journal. 2017; 10 (4): 16-9. doi: 10.21516/2072-0076-2017-10-4-16-19 (In Russian).

Purpose: to study the effectiveness of aflibercept in the treatment of neovascular age-related macular degeneration (AMD) combined with cataract phacoemulsification with intraocular lens (IOL) implantation. Material and methods. A short-term, prospective, controlled, non randomized comparative study of the effect of aflibercept on the changes of visual acuity, the morphometric parameters of the macular area of the retina, and the immunological ophthalmologic status was carried out on 31 patients with neovascular AMD within 1 month after medication usage start. Results. Intravitreal injection of aflibercept leads to a decrease in diffuse retinal edema in the macular area, the size of neuro- and pigment epithelium detachment, and the size of choroidal neovascularization, which in a number of cases was accompanied by an increase in visual acuity, especially with a simultaneous surgical treatment of cataract. Phacoemulsification with IOL implantation neither deteriorates the course of AMD nor affects aflibercept efficacy. The determination of the immune status of tears in the early period after intravitreal administration of aflibercept could not be seen as a relevant method of drug effectiveness assessment. Conclusion. Intravitreal administration of vascular endothelial growth factor inhibitor, aflibercept (Eilea, Bayer Pharma AG, Germany) is an effective method of neovascular AMD treatment including the cases of simultaneous cataract surgery. For citations: Kuznetsov A.A., Tur E.V., Zurochka A.V., Rykun V.S. Efficacy of aflibercept in patients with neovascular age-related macular degeneration when combined with cataract surgery Russian ophthalmological journal. 2017; 10 (4): 20-8. doi: 10.21516/2072-0076-2017-10-4-20-28 (in Russian).

Purpose: to estimate the change of uveitis activity using Behcet’s disease ocular attack score 24 (BOS24) during anti-inflammatory and immunosuppressive therapy of Behcet's disease (BD) patients. Material and methods. 144 out of 205 patients (70.2 %) with confirmed BD diagnosis (according to the criteria set out in ISGBD, 1990) had ocular lesions, 83 of 144 (57.6 %) had acute uveitis, 145 eyes displayed active inflammation. Uveitis activity was estimated in dynamics using BOS24 score, which consisted of 6 parameters with the maximum level of 24 points. Results. The initial average BOS24 score for 145 eyes with active uveitis was 7.38 ± 0.71 points. The most pronounced inflammatory changes were revealed in posterior pole areas - mostly in retina periphery, less frequently in the area of fovea and the optic disc. All patients with uveitis exacerbation received systemic therapy including glucocorticoids, cyclosporine and/or azathioprine. After 9.43 ± 2.47 months of therapy, the average BOS24 score dropped significantly (р < 0.001) to 1.86 ± 0.48. The most notable positive changes were revealed in the anterior chamber (р < 0.001), the vitreous (р = 0.002) and in retinal periphery (р < 0.001). Conclusion. BOS24 is a reliable tool allowing a quantitative assessment of uveitis activity in BD patients and its change after anti-inflammatory and immunosuppressive therapy. For citations: Neroev V.V., Davydova G.A., Katargina L.A., Lisitsyna T.A., Khatagova Z.R., Alekberova Z.S. Evaluation of uveitis activity in Behcet's disease patients using BOS24. Russian ophthalmological journal. 2017; 10 (4): 30-7. doi: 10.21516/2072-0076-2017-10-4-30-37 (In Russian).

Purpose: to analyze the structure of ocular traumas among the population of Volgograd and Volgograd region and estimate the changes of its main parameters for 2013-2015. Material and methods. Eye injury structure of adults and children was analyzed by medical records of Volgograd regional Clinical Hospital No.1, Main Office for medical and social inspection in the Volgograd region, Volgograd regional analytical сenter for medical information. Results. In 2013-2015, the number of hospitalized patients with ocular trauma mainly fell mainly due to a drop in occupational injuries number. Ocular trauma peaks may occur in emergency situations, as was the case of terrorist acts in Volgograd region in 2013. Even though male ocular trauma is prevalent, an increase of ocular trauma in women was detected which is due to the character of social roles and employment of women in the Russian society. The highest frequency of eye injuries in children and adults is claimed by domestic and street traumas. The incidence of disability due to severe ocular damages decreased as a consequence of the general trends in ocular trauma and the improvement in the quality of ophthalmologic service quality. Conclusion. Ocular trauma can be reduced by improved quality of ophthalmologic service and preventive measures. For citations: Petrayevsky A.V., Gndoyan I.A., Trishkin K.S., Vinogradov A.R. Current tendencies in ocular traumatism revealed by the analysis of its parameters among the population of Volgograd region in 2013-2015. Russian ophthalmological journal. 2017; 10 (4): 39-47. doi: 10.21516/2072-0076-2017-10-4-39-47 (In Russian).

Purpose: to study the choroidal thickness in children with varied refractions and its dynamics after sclera reinforcement treatment. Material and methods. The study involved two groups: (1) 78 children (average age 12.54 ± 0.35 yrs) with mild hyperopia, low, moderate and high myopia and (2) 40 children with moderate and high myopia who received low invasive (LSP, average age 12.00 ± 0.51 yrs.), or bandaging scleroplasty (BSP, average age 12.33 ± 0.35 yrs) according to Snyder and Thompson and were examined prior to and after the procedure. All patients underwent a standard ophthalmologic examination and had choroid thickness (CT) manually measured by EDI-SD-OCT technique. Results. In group 1, a drop in CТ with refraction growth and axial elongation was found. In group 2, the CT change was traced: in the operated eyes, СТ increased by 34.7 ± 3.15 μm after LSP and by 53.7 ± 1.19 μm after BSP. In fellow eyes, CT showed an increase of 25.4 ± 1.79 μm after LSP and 32.20 ± 0.59 μm after BSP. Conclusions. In the early period after sclera strengthening operations, СТ significantly increases both in the operated and in the fellow eye. Аn increase of CТ probably stimulates collagen biosynthetic activity of the scleral matrix and collagen synthesis, and boosts the inhibitory effect of scleroplasty with regard to myopia progression. For citations: Tarutta E.P., Markossian G.A., Sianosyan А.А., Milash S.V. Choroidal thickness in varied types of refraction and its changes after sclera-strengthening surgeries. Russian ophthalmological journal. 2017; 10 (4): 48-53. doi: 10.21516/2072-0076-2017-10-4-48-53 (In Russian).

The deterioration of the corneal framing function in keratoconus is largely due to the dystrophic process and the decrease of collagen structures crosslinking level. The purpose of the study is to perform a preclinical placebo controlled study of the safeness and effectiveness of Cornetex compound instillations for medicament corneal crosslinking. Material and methods. The study included 37 Chinchilla rabbits (74 eyes). 33 rabbits received Cornetex solution instillations into one eye twice a day for 1 month (17 rabbits, 1st series) and for 3 months (16 rabbits, 2nd series). The active constituents of Cornetex include a complex of the basic amino acid salts in the form of succinates (residues of succinate acid) participating in collagen crosslinking formation. The placebo solution containing nonactive Cornetex constituents (Hydroxyethyl cellulose, benzalkonium chloride and water for injections) was instilled into fellow eyes. 4 fully intact rabbits (8 eyes) served as an independent control group. In vivo methods included biomicroscopy and examination with a Scheimpflug camera Galilei G2. 1 and 3 months after the instillation course, the eyes were enucleated and subjected to a morphological study, biomechanical testing of corneal samples (on the testing machine Autograph AGS-H). Corneal collagen crosslinking level was determined by differential scanning calorimetry using a Phoenix DSC 204 calorimeter. Results. Biomicroscopic and morphological studies revealed no pathological changes of ocular media and tissues. One month after the instillation course, the collagen crosslinking level of the cornea showed a 18 to 20 % increase, while its elasticity modulus showed a 1.8-fold increase with respect to the fellow eye, which is an evidence of the safety and high corneal reinforcement effect of the instillations. Conclusions. The outcome of the experimental study of Cornetex implies that it can be recommended for further clinical studies as a promising means for keratoconus treatment. For citations: Iomdina E.N., Korigodsky A.R., Khoroshilova-Maslova I.P., Andreeva L.D., Ignatieva N.Yu. An experimental study of the composition for medicament corneal crosslinking as a promising means for keratoconus treatment. Russian ophthalmological journal. 2017; 10 (4): 54-61. doi: 10.21516/2072-0076-2017-10-4-54-61 (In Russian).

Purpose. To conduct an experimental and clinical study of a hypotensive effect of implantation of an improved carbon drainage with an optimized sorption capacity. Material and methods. The study involved the eyes of 50 Chinchilla rabbits divided into 3 groups, depending on the diameter of the drainage, multifilament carbon: 150, 450 and 600 μm. The results were assessed over a 15-month period. Once a week, biomicroscopy and tonometry using a Maklakov tonometer (with the load of 10.0 G) was conducted. Once every 3 months, ultrasound and endothelial biomicroscopy was performed. Results. The ability of the developed drainage to significantly reduce IOP by improving the outflow of intraocular fluid was confirmed. Implantation was shown to cause no damage to corneal endothelium. Conclusion. The positive results obtained are an evidence of good prospects of using multifilament carbon for drainage in glaucoma surgery. For citations: Stepanov A.V., Zolkin P.I., Gamzaeva U.Sh. Prospects of application of high-tech carbon material as drainage in glaucoma surgery. Russian ophthalmological journal. 2017; 10 (4): 63-7. doi: 10.21516/2072-0076-2017-10-4-63-67 (In Russian).

Purpose: to develop the concept of a histohematic barrier on the basis of continuous clinical and functional observations and experimental studies. The structure of histohematic barriers is primarily determined by the structure of the organ and has specific parameters depending on morphological features. The main structural elements of histohematic barriers are blood capillaries whose endothelium has different morphological features in different organs and tissues. According to the concept developed, the hematoophthalmic barrier is composed of three interrelated systems: 1) iridociliary system (hematociliary barrier); 2) chorioretinal system (hematoretinal barrier); 3) papillary system (hematopapillary barrier). In the case of normal operation, these three systems support the normal homeostasis of the eye. For citations: Morozov V.I. A hematoophthalmic barrier: structural and functional features. Russian ophthalmological journal. 2017; 10 (4): 68-72. doi: 10.21516/2072-0076-2017-10-4-68-72 (In Russian).

The importance of vernal keratoconjunctivitis (vernal conjunctivitis, or vernal catarrh) is not so much due to its level of prevalence (today its occurrence amounts to 1.25-11.29 per 10 000 population of European countries), but rather to the severity of its clinical course. Especially significant is its tarsal form, which is complicated in 3-11 % of vernal keratoconjunctivitis patients by the development of corneal ulcers. Such patients are normally treated by antiallergic agents, which offer both antihistamine and mast cell-stabilizing action. Primarily, the medicines used are 0.1 % olopatadine and 0.025 % ketotifen, which can also reduce the activation of eosinophils and the production of pro-inflammatory cytokines. The therapy of resistant forms of the disease is successfully supplemented with instillations and / or ointment forms of glucocorticoids, cyclosporine-A, tacrolimus and mitomycin-C. Giant papillae that cause gravitational ptosis or are combined with the torpid current of the disease require surgical treatment. They are excised (or cryodestructed) with intraoperative treatment of the tarsal conjunctiva with 0.02 % mitomycin-C and subsequent instillations of cyclosporine-A. There is a need to further develop and introduce into clinical practice new pathogenetically oriented medicinal preparations which provide both relief of clinical symptoms of the disease and the prevention of its relapses. For citations: Brzheskiy V.V. On the prevalence of vernal keratoconjunctivitis and current possibilities of treatment. Russian ophthalmological journal. 2017; 10 (4): 74-81. doi: 10.21516/2072-0076-2017-10-4-74-81 (in Russian).

Purpose: to study the possibilities of the three-component substitute for tears (Stillavit®) in the prevention of combined dry eye syndrome after cataract surgery. Material and methods. 60 patients (60 eyes) aged 55 to 82 (ave. 69.7 ± 7.5 years) with subclinical dry eye syndrome of various genesis were operated for cataract. The patients were divided into two clinical groups depending on the type of post-surgical therapy; the main group of 30 patients (30 eyes) who received standard treatment (ophthalmic corticosteroid and antibacterial drugs 4 times a day) and lacrimal replacement therapy with Stilavit® 4 times a day for 7 days, and the control group of 30 patients (30 eyes) who only received standard postoperative treatment for 7 days. Examination setting included biomicroscopу with vital dyes, a Schirmer test, a Norn test, an evaluation of the lacrimal meniscus index, and the degree of epitheliopathy of the conjunctiva and the cornea. Results. Patients with subclinical dry eye syndrome who received corneal surgery with cataract phacoemulsification and IOL implantation are at risk of a complication of the course of dry eye syndrome and the development of a combined dry eye syndrome. Inclusion of the Stilavit® instillation in the early postoperative period 4 times a day for 7 days significantly increases the stability of the pregroovy tear film and lessens the degree of the epitheliopathy of the conjunctiva and the cornea. Conclusions. Based on the examination data, we can recommend a three-component substitute for tears (Stilavit®) for the prevention of the development of combined dry eye syndrome after cataract surgery. For citations: Shurygina I.P., Akulov S.N., Kabardina E.V., et al. A three-component substitute for tears (Stillavit®) in the prevention of combined dry eye syndrome after cataract surgery: usage experience. Russian ophthalmological journal. 2017; 10 (4): 82-8. doi: 10.21516/2072-0076-2017-10-4-82-88 (In Russian).

The article highlights the modern aspects of etiology and pathogenesis of the development of retinal dystrophies associated with myopia and age-related macular degeneration. Special consideration is given to issues of choroidal neovascularization in cases when both pathologies take place. For citations: Alekseev I.B., Nam Ju.A., Nepesova O.M. Pathogenetic issues of retinal dystrophies associated with myopia and age-related macular degeneration. Russian ophthalmological journal. 2017; 10 (4): 90-6. doi: 10.21516/2072-0076-2017-10-4-90-96 (In Russian).

Literary data on the choice of eye removal procedure - enucleation or evisceration - for sympathetic ophthalmia (SO) prevention is presented. In severe penetrating eye injuries when it is impossible to restore eye anatomy during primary surgical treatment and correct light projection is absent, primary evisceration of the damaged eye is recommended. Preventive evisceration should be performed within 2 weeks after injury, which is considered a safe period when SO can be avoided as progressive reduction and scarring of the scleral capsule of the eye has not yet occurred. Evisceration is also recommended for patients with posttraumatic complications consequences and subatrophia with cosmetic purposes. With modern technologies of ophthalmoplastic surgery evisceration, has a number of advantages over enucleation as it provides better stability and motility, fewer complications, good cosmetic results and low risk of developing SO. Enucleation is recommended for patients with chronic posttraumatic uveitis in absence of correct light projections and risk factors of SO. Enucleation is performed with protection of immunosuppressive therapy that should last at least 4 to 6 weeks after the surgery. In case of SO onset, the sympathetic eye should be removed by enucleation as early as possible. For citations: Arkhipova L.T., Filatova I.A. Prevention of sympathetic ophthalmia: enucleation or evisceration? Russian ophthalmological journal. 2017; 10 (4): 97-103. doi: 10.21516/2072 0076-2017-10-4-97-103 (In Russian).

The review addresses issues of classification, typical morphological processes and pathogenesis of secondary cataract types, as well as patterns of lens posterior capsule folds. Keywords: secondary cataract, lens posterior capsule opacification, cataract surgery, intraocular lens, posterior capsule folds, Nd: YAG laser posterior capsulotomy. For citations: Toropygin S.G., Glushkova E.V. Secondary cataracts after in-the-bag intraocular lens implantation: pathomorphology, pathogenesis and types. Part 1. Russian ophthalmological journal. 2017; 10 (4): 105-12. doi: 10.21516/2072-0076-2017-10-4-105-112 (In Russian).