Purpose of the study was to assess the effectiveness of orthokeratological lenses (OCL) in the correction of progressive myopia in children with retinopathy of prematurity (ROP) on the basis of long-term (up to 4 years) dynamic follow-up.

Material and methods. The study included 150 children aged 8–12 years (mean 10.2 ± 1.3 years) with ROP and progressive myopia from –0.75 to –8.25 D. In the study group (n = 125), nocturnal OCL (E-System, Boston XO) were used. Children in the control group (n = 25) were prescribed soft contact lenses.

Results. The duration of lens use was 12–48 months (average 32.1 ± 2.4 months). In 60 % of patients in the study group, a slow progression of myopia was observed, i.e., an increase in refraction by 0.25–0.5 D per year; in 30 % of patients, a rapid progression (more than 1 D per year) requiring especially careful monitoring and correction; in 10 % of children, myopia was stable, with an increase of less than 0.25 D per year. The use of OCL in all patients made it possible to achieve visual acuity without correction at the end of follow-up of 0.98 ± 0.06 (baseline 0.09 ± 0.08). The increase in myopic refraction averaged –0.43 ± 0.22 D (2 times lower than in the control group), the axial length of the eye increased by 0.06 ± 0.03 mm.

Conclusion. Orthokeratology demonstrates high efficiency in stabilizing mild and moderate myopia in children with ROP, reducing the need for constant optical correction.

A high prevalence of primary angle-closure glaucoma (PACG) has been reported in the Sakha Republic (Yakutia).

The purpose of this study was to identify biometric features of the anterior segment of the eye associated with the risk of PACG in patients of the Yakut and European populations. This retrospective cross-sectional study included 281 patients with cataract (422 eyes) aged 68,58 ± 6,94 including 79 patients (106 eyes) of the European population and 202 patients (316 eyes) of the indigenous inhabitants of the Republic of Sakha (Yakutia) — Yakuts, examined by optical biometry (Lenstar LS 900).

Results. It was found that Yakuts without glaucoma, compared with Europeans, have significantly lower central corneal thickness (CCT), corneal diameter (WTW), anterior chamber depth (ACD), and relative lens position (RLP), indicating a more anterior position of the lens. Logistic regression identified three independent predictors of ethnicity associated with the risk of PACG: values of CCT, WTW, and RLP. The combined CCT + WTW + RLP model demonstrated satisfactory discriminatory ability (AUC = 0.743). A comparison of PACG surgical techniques in Yakuts revealed that phacoemulsification of cataracts (PEC) provides a deeper anterior chamber and significantly lower IOP in the long-term period compared to laser iridectomy.

Conclusion. The complex of biometric features identified in Yakuts explains the high risk of PACG. PEC should be considered a priority method for the surgical treatment of PACG in this ethnic group.

According to the Volkov chair of ophthalmology, the incidence of eye injuries during modern armed conflicts (MACs) is 12.3–20.4 %. In addition to damage to the eye and adnexal structures, eye injuries also include orbital combat trauma (OCT), which accounts for 20–37 % of eye injuries. During MACs, the incidence of combat trauma (CT) with orbital foreign bodies (OFB) was 47.9 % of all OFBs. OFBs in MACs may be accompanied by pain, oculomotor disorders, and infectious complications that threaten not only vision but also the patient’s life.

The purpose of the study was to determine the indications and contraindications for FB removal in orbital MACs.

Material and methods. The prospective study included 69 patients treated for OFBs in MACs at the clinics of the Kirov Military Medical Academy.

Results. An absolute indication for FB removal is the presence of a purulent-inflammatory process in the orbit. Relative indications for FB removal include their medium (1–1.5 cm) and large (> 1.5 cm) size, location in the anterior third of the orbit and independent palpation by the patient, diplopia, and impaired position and mobility of the eyeball or its musculoskeletal stump. Contraindications to FB removal include surgical interventions involving opening of the fibrous capsule of the eyeball and/or for open eye trauma within the previous 30 days.

Conclusion. The choice of treatment strategy is substantiated, and indications and contraindications for FB removal in BT are defined, allowing for increased treatment effectiveness.

Purpose. To compare the effectiveness of orthoptic training and prism correction in the management of convergence insufficiency (CI) among young adults.

Material and methods. A prospective comparative clinical trial was conducted on 60 young adults aged 18–25 years diagnosed with CI. Participants were randomly assigned to Group A (orthoptic training; n =3 0) or Group B (prism correction; n = 30). Group A underwent 6 weeks of supervised orthoptic exercises (pencil push-ups, brock string, jump convergence, computer-based therapy), while Group B received base-in prisms prescribed according to Sheard’s criterion. Outcome measures included near point of convergence (NPC), positive fusional vergence (PFV), Convergence Insufficiency Symptom Survey (CISS), stereoacuity, and reading speed.

Results. Group A showed significant improvement in NPC (13.5 ± 2.8 cm to 7.2 ± 1.8 cm; p < 0.001), PFV (12.4 ± 3.1 Δ to 22.8 ± 4.2 Δ; p < 0.001), and CISS score (31.6 ± 5.2 to 15.8 ± 4.0; p < 0.001). Group B demonstrated smaller improvements in NPC (13.3 ± 2.5 cm to 10.5 ± 2.2 cm; p = 0.002), PFV (12.1 ± 2.9 Δ to 14.5 ± 3.3 Δ; p = 0.04), and CISS (31.3 ± 5.5 to 22.6 ± 5.1; p < 0.001). Stereoacuity improved significantly in Group A (140 ± 35 arc sec to 80 ± 25 arc sec; p < 0.01), but not in Group B. Between-group comparisons confirmed superior outcomes in Group A across primary measures (p < 0.01).

Conclusion. Both interventions were effective, but orthoptic training provided superior improvements in vergence parameters, symptom reduction, and stereoacuity. Prism correction may serve as an adjunct for immediate symptomatic relief, while orthoptic therapy should be prioritized for long-term management.

Purpose: to evaluate the effect of removal and preservation of the internal limiting membrane (ILM) on the density of the microvascular bed (in the superficial and deep vascular plexuses of the retina) and retinal thickness in the macular region in older patients operated on for idiopathic epiretinal fibrosis (ERF).

Material and methods. The retrospective study included 103 patients (103 eyes) aged from 56 to 78 years (mean 67.1 ± 7.8 years) who underwent surgical treatment of idiopathic ERF. The patients were divided into 2 groups: the main group — where the ERF was removed while preserving the ILM (67 eyes) and the control group — where the ERF was removed along with the ILM (36 eyes). The vascular density of the superficial vascular plexus (SVP), deep vascular plexus (DVP) and retinal thickness were assessed using optical coherence tomography with angiography function. The period of observation of patients ranged from 6 months to 3 years.

Results. When the ILM was preserved in all analyzed areas of the retina, the indicators of the density of the SVP and DVP were comparable with the indicators of the group of healthy individuals of the same age. The retinal thickness in all analyzed areas was not statistically different from the retinal thickness of healthy people. When the ILM was removed, the density of SVP was reduced in all analyzed areas of the retina compared with similar indicators in healthy patients. The density of DVP in the foveal area was reduced compared to this indicator in the control group and remained unchanged in other analyzed areas. Retinal thickness in all analyzed areas was reduced relative to retinal thickness in healthy people of the older age group.

Conclusion. Preservation of the ILM after removal of idiopathic ERF does not lead to a decrease in the density of the vascular bed and a decrease in retinal thickness. Removal of the ERM together with the ILM causes a decrease in the density of SVP and the retinal thickness around ILM removal. The density of DVP remains unchanged in all zones, except for the foveal area, where it decreases in the long-term postoperative period (from 6 months to 3 years). Surgery for idiopathic ERF with preservation of the ILM is a more appropriate technique in terms of preserving normal anatomical parameters of the microvascular bed and retinal thickness.

The purpose of the work was to study the effect of bandage scleroplasty (BSP) on the level of dopamine (DA) in the tear fluid and choroidal thickness (CT) in patients with high progressive myopia.

Material and methods. Fifty patients (50 eyes) aged 13.1 ± 1.7 years were examined and divided into 3 groups: Group 1 — children with congenital myopia (spherical equivalent (SE) = 14.5 ± 3.4 D), Group 2 — with acquired myopia (SE = 8.3 ± 1.5 D); Group 3 (control) — with emmetropia and low hyperopia (SE = +0.25 ± 0.7 D). In addition to the routine examination, the children’s eye axial length (AL), choroidal thickness (CT) using the SLO/OCT Mirante multimodal platform (Nidek, Japan), and retinal light sensitivity (RLS) in the macular area using the MP-3 microperimeter (Nidek, Japan) were determined. Biochemical studies of tear fluid were also performed to determine the DA concentration before and 1 month after BSP.

Results. In congenital myopia, DA after BSP decreases (by an average of 77 pg/mg protein), while in acquired myopia, it tends to increase (by an average of 20 pg/mg protein) with an increase in CT (by 13.0–20.3 %) in both groups. In patients with congenital myopia and initially low DA values, no normalization of hormone concentrations was observed after BSP, despite improved choroidal blood filling. However, with initially elevated DA levels, its concentration in tears decreased after BSP, accompanied by an increase in CT.

Conclusion. BSP promotes an increase in CT in both acquired and congenital myopia. In congenital myopia, DA decreases after BSP, while in acquired myopia, it increases, which may be due to the preservation of retinal dopaminergic cells capable of synthesizing DA.

Bleb needling aims to restore aqueous humor filtration by mechanically dissecting established subconjunctival adhesions and modifying the architecture of the filtration zone. Various pharmacological adjuvants are used to prolong the hypotensive effect and modulate the wound response in the filtration cushion zone; however, the effectiveness of different groups of drugs for needling requires clarification.

Purpose: comparative analysis of the efficacy and safety of needling after glaucoma surgery using different adjuvant agents.

Materials and methods. A retrospective comparative analysis of 123 patients (123 eyes) divided into three groups based on the adjuvant used (dexamethasone, 5-fluorouracil, aflibercept) was conducted. The primary endpoint was complete hypotensive success. Intraocular pressure (IOP) dynamics, reoperation rates, and complications were assessed.

Results. Complete success was achieved in 32.4 % of patients in the dexamethasone group, 41.7 % in the 5-fluorouracil group, and 60.5 % in the aflibercept group. Aflibercept significantly increased the likelihood of success compared with dexamethasone (RR = 1.87; 95 % CI 1.10–3.17; p = 0.015) and showed a trend toward superiority over 5-fluorouracil (RR = 1.45; 95% CI 0.97–2.17; p = 0.10). No differences were found between 5-fluorouracil and dexamethasone. The mean IOP at 6 months was significantly lower in the aflibercept group. The safety profile was comparable across all groups; no significant differences in complication rates were found.

Conclusions. The use of an antiangiogenic adjuvant provides a more pronounced and persistent hypotensive effect of needling compared to dexamethasone and shows a tendency to be superior to 5-fluorouracil in achieving hypotensive success.

The primary surgical method for slowing the progression of high myopia, stabilizing refraction, and preventing potential fundus complications, including the development of posterior scleral staphyloma, is reinforcement of the posterior pole of the eye.

Purpose. To conduct a comparative analysis of changes in ocular hemodynamics following scleral reinforcement surgery in patients with congenital and acquired myopia in the macular and optic nerve head (ONH) areas.

Materials and methods. The study included 42 patients (42 eyes) aged 13.0 ± 1.8 years with progressive high myopia, divided into two groups: Group 1 — congenital myopia with a spherical equivalent of –13.5 ± 3.0 D and an axial length of 28.9 ± 1.8 mm (n = 16); Group 2 — acquired myopia with a spherical equivalent of –8.5 ± 1.5 D and an axial length of 26.8 ± 0.8 mm (n = 26). All patients underwent scleral reinforcement surgery using a modified Snyder — Thompson technique. Choroidal thickness (CT) was measured using the multimodal SLO/OCT Mirante platform (Nidek, Japan). Blood flow assessment via the mean blur rate (MBR) parameter was performed using laser speckle flowgraphy (LSFG-RetFlow, Nidek, Japan) in the macular area and ONH region preoperatively and at 1, 6, and 12 months postoperatively.

Results. A significant (p ≤ 0.05) 1.4-fold reduction in choroidal thickness (CT) was revealed in patients with high congenital myopia compared to those with acquired myopia, with no differences in blood flow velocity (MBR). Patients with congenital myopia and posterior staphyloma demonstrated a significant (p ≤ 0.05) decrease in choroidal blood filling and macular blood flow. Following surgery, the positive dynamics of CT and MBR parameters were maintained longer during long-term follow-up in patients without staphyloma compared to those with staphyloma.

Conclusion. Scleral reinforcement surgery had a pronounced effect on blood flow in the posterior pole of the eye in patients with congenital and acquired myopia and stimulated ONH hemodynamics only marginally and exclusively in the congenital myopia group.

Postoperative follow-up is an important element of the system for ensuring the safety and satisfaction of cataract patients. Existing approaches to the regulation of follow-up time do not allow to fully implement the strategy of early detection of postoperative complications, which requires the search for new solutions and complex evaluation of their effectiveness.

Purpose: to improve the safety of cataract surgery by optimizing the postoperative follow-up.

Materials and methods. A comparative cohort study in 2 groups of patients undergoing cataract surgery included 1951 patients in the main group and 2436 patients in the control group. In the control group of patients, the examination was scheduled within the terms regulated by the clinical recommendations on the 1st, 7rd, 28th day after the intervention. In the main group of patients, the second visit was scheduled on the 3rd day after surgery. The main outcome for assessing the efficacy of the follow-up regimens was the early detection of postoperative complications. Additional efficacy criteria were the visual acuity values after cataract phacoemulsification compared to the control group.

Results. Clinical and functional outcomes in both groups did not differ with respect to visual acuity and intraocular pressure parameters before and after surgery (p > 0.05), demonstrating the achievement of a best corrected visual acuity (BCVA) of 0.9 ± 0.2 at 7 days after surgery. A visit at 3 days postoperatively significantly increased the probability of early detection of acute postoperative endophthalmitis (p = 0.018). As a result of endophthalmitis treatment, patients in the main group had an BCVA ³ 0.3, patients in the control group £ 0.2.

Conclusions. Optimization of the monitoring regime of patients after surgery includes shifting the examination period from 7 to 3 days after the procedure, which provides a statistically significant reduction of the risks of late diagnosis (more than 1 day after manifestation) and improves the results of acute postoperative endophthalmitis treatment, thus increasing the safety of cataract surgery.

Purpose of the study: to evaluate and compare morphometric parameters (biomarkers) of the retina and choroid obtained using optical coherence tomography angiography (OCTA) in patients with chronic heart failure with preserved ejection fraction (HFpEF).

Material and methods. The study included 32 patients (61 eyes) with a verified diagnosis of HFpEF and 30 healthy individuals (62 eyes) in the control group, matched for age and sex. Patients in the study group were divided into three subgroups according to the functional class (FC) based on the New York Heart Association (NYHA) classification: FC I — 10 patients (20 eyes), FC II — 13 patients (23 eyes), FC III — 9 patients (18 eyes). All participants underwent OCTA using a DRI OCT-Triton device (Topcon, Japan). The assessed parameters included foveal avascular zone (FAZ) area, vessel density (vd) in the superficial (SCP) and deep (DCP) capillary plexuses, in the choriocapillaris (CC) layer, and in the choroid (C).

Results. Patients with HFpEF demonstrated a statistically significant reduction in mean vessel density in the DCP (mean vd DCP, p = 0.009), in the CC (p = 0.004), as well as in the inferior (p = 0.019) and temporal (p = 0.012) sectors of the choroid compared to the control group. Topical specificity of the damage was observed: the most pronounced changes in the CC were recorded in the inferior sector of the paramacular zone (p = 0.004). Intragroup analysis revealed a progressive decrease in mean vd CC with increasing NYHA FC. Correlation analysis showed a moderate negative relationship between NYHA FC and CC vessel density (ρ = –0.335, p = 0.018), as well as between NYHA FC and choroidal vessel density in the superior sector (ρ = –0.345, p = 0.015).

Conclusion. HFpEF is associated with multi-level microcirculatory changes in the retina and choroid, which are sectorally heterogeneous. OCTA biomarkers, such as mean vessel density of the DCP and mean vessel density of the choriocapillaris layer, may be recommended as an early and non-invasive monitoring tools for systemic microcirculatory dysfunction in patients with HFpEF.

Purpose of the study: to assess the one-year dynamics of structural and microcirculatory changes in the retina and optic nerve head in patients with multiple sclerosis (MS) depending on the disease course and to determine their relationship with clinical and neurological characteristics.

Materials and methods. The study included 33 patients (66 eyes) with MS: group 1 — 13 patients (26 eyes) with relapsingremitting multiple sclerosis (RRMS), group 2 — 9 patients (18 eyes) with disease progression during the follow-up period, group 3 — 11 patients (22 eyes) with secondary progressive multiple sclerosis (SPMS). All patients underwent OCT and OCT angiography at two time points with an interval of 12 ± 2 months. The following parameters were assessed: average ganglion cells layer + inner plexiform layer thickness (avGCL + IPL), average retinal nerve fiber layer thickness (avRNFL), their sectoral values, and vascular density of the optic nerve head (VD ONH).

Results. A decrease in avGCL + IPL was detected in all groups, while the pattern of sectoral changes depended on the type of disease course. A significant decrease in avRNFL was found only in the RRMS ® SPMS group. A tendency toward a decrease in VD ONH was observed in all groups; however, a statistically significant reduction was detected only in patients with SPMS. The most pronounced correlations were found between VD ONH and GCL + IPL parameters, whereas the relationships of EDSS and SDMT with ophthalmic parameters were less consistent.

Conclusions. The most consistent changes in patients with MS over 1 year were detected in GCL + IPL parameters. VD ONH may be considered as an additional marker of disease progression when interpreted together with structural parameters.

Purpose of the study — to determine the causes of significant differences in optical coherence tomography angiography (OCTA) quantitative metrics in the central zone and the inner ring of the ETDRS grid and to develop methods for their correcting.

Material and methods. Manuals for the most common OCTA devices of various manufacturers Carl Zeiss Meditec (USA), Optovue (USA), Topcon Corp. (Japan), Optopol Technology (Poland), Huvitz Co. (South Korea) were studied. OCTA data of 57 people (57 eyes) over 18 years old with refraction close to emmetropia were analyzed. OCTA examinations were performed on a Cirrus HD-OCT 5000 device (Carl Zeiss Meditec, USA). The perfusion density, vessel density and foveal avascular zone (FAZ) area of the superficial capillary plexus were determined. OCTA images of the macula were acquired using the 6 × 6 mm scan.

Results. It was found that in most devices, including Cirrus HD OCT, the calculation of indicators in the central zone of the ETDRS scheme d = 1 mm is performed by dividing by the entire area of the central zone without taking into account the area of the FAZ. As a result, the quantitative metrics of the central zone are significantly underestimated. A correction formula has been proposed to calculate OCTA parameters adjusted for the size of the FAZ. It has been shown that the correction increases the quantitative metrics of the superficial capillary plexus in the central zone of the ETDRS grid by about 1,5 times, approaching their values to the indicators in the inner ring of the ETDRS grid.

Conclusion. Correcting the values to account for the FAZ area provides more accurate characterization of the quantitative OCTA indicators in the central zone.

Lacrimal gland (LG) neoplasms vary in biological aggressiveness and prognosis, but often present with similar clinical features. Instrumental methods offer limited and nonspecific opportunities for differential diagnosis. Histological examination of tumor biopsy material remains the diagnostic gold standard. Despite published data, no consensus has been reached on the optimal treatment strategy for these patients. Preoperative noninvasive differentiation between malignant and benign LG neoplasms is therefore essential for choosing patient management, including the need, timing, and extent of surgery, which directly affects vital prognosis. We describe a rare case of primary ductal adenocarcinoma of the LG that for a long time mimicked a benign cystic lesion, and present the clinical, instrumental, and morphological findings.

The article presents a clinical case of a 28-year-old female patient undergoing systemic isotretinoin therapy for acne, who developed pronounced meibomian gland dysfunction and dry eye syndrome. Standard treatment with anti-inflammatory agents, tear substitutes, and eyelid massage failed to produce satisfactory results. Consequently, a decision was made to initiate reversible cold electroporation therapy using a high-frequency direct current generator on the Jett Medical OPH device. The procedure was performed as a course of three sessions spaced 7 days apart. Following treatment, significant clinical improvement was observed: eyelid hyperemia and edema decreased, meibomian secretion mobility improved, tear break-up time and lipid layer thickness increased, and the patient’s subjective symptoms markedly diminished. The Ocular Surface Disease Index (OSDI) score decreased from 34 to 15, and the frequency of tear substitute instillation was reduced from 20–30 times to 2 times per day. Conclusion. Application of reversible electroporation demonstrated high efficacy and safety, making it a promising treatment option for patients with ocular complications associated with systemic retinoid therapy, particularly in cases where intense pulsed light therapy is contraindicated.

Molluscum contagiosum is a benign skin and mucous membrane disease caused by a virus of the Poxviridae family, prone to spontaneous regression at varying times after infection. This review examines the etiology, prevalence, routes of infection, lesion location, pathological presentation, and treatment methods for molluscum contagiosum. The article also presents a case of its extremely rare conjunctival localization.

Choroidal melanoma (CM) originates from melanocytes residing in the uveal tract due to their malignant transformation. It affects the choroid and is considered the most frequent primary intraocular cancer in adulthood, comprising 85 % of all eye neoplasms and is associated with high metastatic risk, which makes it one of the most aggressive tumors. Despite earlier successful local treatment of the primary tumor, up to half of all CM patients will eventually develop metastatic disease, particularly to the liver, which makes survival prognosis poor. One of the factors that initiates melanocytic malignant transformation is genetic predisposition. In some cases, CM presents with extrascleral extension forming extrabulbar tumor foci. The literature suggests that extraocular tumor extension has been noted to occur in up to 2–3 % of cases primarily presenting with uveal melanoma and is associated with poor vital prognosis and more aggressive disease course. Herein, we report a case study of long-standing choroidal melanoma that has resulted in significant transscleral tumor growth and its intracranial extension presenting no signs of metastatic disease at the time of presentation to the Burdenko Neurosurgical Center.

Iris injuries may cause diplopia, glare, photophobia, cosmetic concerns, and a significant decrease in visual acuity. The choice of surgical treatment depends on the extent of the iris defect. If the damaged area is less than 30 %, closed iridoplasty is usually performed. Various iris reconstruction techniques have been proposed, each with its own advantages and limitations. However, in some cases, the pupil formed after iridoplasty may be irregular in shape and displaced from the main optical axis of the eye. In such situations, an additional laser optical-reconstructive procedure may be performed as a second stage. Purpose: to evaluate the functional and cosmetic outcomes of iridoplasty followed by laser pupil centration in patients with traumatic iris injury. Material and methods. We analyzed the surgical treatment of 10 patients with traumatic iris injury. All patients underwent closed iridoplasty as the first stage, followed by laser pupil centration using a 532-nm diode laser as the second stage. The article presents a clinical case of two-stage treatment of an iris defect after penetrating ocular injury. A 46-year-old woman presented with complaints of decreased vision in the right eye, glare, photic phenomena, and cosmetic discomfort. In addition to standard clinical and functional examinations, including visual acuity testing, biomicroscopy, and pneumotonometry, ultrasound biomicroscopy was performed. Laser pupil centration was carried out three weeks after iridoplasty. Results. Iridoplasty resolved the patient’s complaints of undesirable visual effects. After laser pupil centration, the pupil was aligned with the main optical axis, round, and 2.5 mm in diameter. Conclusion. Two-stage treatment of small iris defects, consisting of iridoplasty followed by laser pupil centration, provides favorable functional and cosmetic outcomes.

Topical steroids are a cornerstone in the management of inflammatory diseases of the anterior segment of the eye, providing potent anti-inflammatory and immunosuppressive effects. The first part of the review [ROJ. 2026; 19 (2): 192–202] presents a comprehensive comparative analysis of the pharmacokinetics of key steroids used in ophthalmology practice — prednisolone, dexamethasone, fluorometholone, hydrocortisone, loteprednol, and difluprednate. At the same time, their use is associated with a potential risk of developing serious adverse reactions, including ocular hypertension, cataracts, delayed reparative processes, and suppression of local immunity. Therefore, the choice of the optimal drug requires a balanced assessment of the expected therapeutic efficacy and safety profile depending on the specific clinical situation. Part 2 of the review focuses on comparing the clinical efficacy of the above-mentioned steroids, assessing the associated risks, and analyzing the pathogenetic mechanisms of their development, primarily steroid-induced ocular hypertension. Differentiated approaches to prescribing are discussed, considering the pharmacological properties of drugs, the localization and severity of the inflammatory process, as well as individual risk factors for the patient.

Today, considerable attention is being paid to the clinical efficacy of new amblyopia treatments, such as TMS and tDCS, as well as perceptual and dichoptic visual training in video games, including those using virtual and augmented reality. The aim is to improve binocular vision and reduce interocular suppression. Recent advances in neuroscience provide new insights into the mechanisms of therapeutic effects and identify new research directions in this area. In particular, studies of evoked and spontaneous neural activity (background noise) are expanding our understanding of visual system function. Normal background neural activity exhibits complex, self-similar scale-free oscillations, the power spectrum of which can be described by a 1/f function. A 1/f-like power spectrum indicates nonlinear, fractal dynamics of neural activity. In amblyopia, the variability of not only evoked but also background neural activity increases, which can negatively affect brain plasticity and the statistical properties of oscillations. The dynamics of background noise determine the variability of the evoked response and may influence brain plasticity. It is believed that the superior efficacy of new amblyopia treatments used today, compared to traditional methods, is due to their ability to better train the brain to distinguish signals from noise, thereby enhancing the reliability of received visual information. On the other hand, fractal photostimulation has been shown to have a positive effect on evoked retinal bioelectrical activity and visual characteristics in patients with various retinal diseases. This may be due to the normalization of the statistical characteristics of neural noise in the visual system, both stimulus-dependent (evoked visual responses) and background noise of spontaneous neuronal activity at rest. It can be hypothesized that the development of new pharmacological and non-pharmacological methods for modulating neuroplasticity will facilitate the restoration of the structure and function of neural networks and the visual rehabilitation of patients with amblyopia.

Visual impairments are an important medical and social issue affecting the life quality and healthcare economy. Cataracts, glaucoma, myopia and age-related macular degeneration are the leading ophthalmologic conditions. Modifiable behavioral factors and environmental influences play a crucial role in these conditions development. The purpose of this work is to systematically analyze and synthesize current scientific data on how lifestyle affects the prevalence and pathophysiology of ophthalmologic diseases. Modifiable lifestyles correlate with increased risk for major ophthalmologic disorders, such as glaucoma. Physical inactivity, obesity, prolonged use of digital screens, and lack of exposure to natural light all contribute to glaucoma development through vascular and metabolic disturbances. Myopia is also linked to prolonged screen time and a lack of outdoor activity, particularly in children. Unbalanced diets with antioxidant deficiencies accelerate degenerative changes in ocular structures. Smoking increases the risk of cataract and age-related eye disease through oxidative stress. Lifestyle modification is a promising approach to primary prevention of eye disorders. Integrating risk factor information and implementing personalized programs tailored to genetic predispositions and behavioral patterns into clinical care and public health initiatives can significantly reduce eye disease prevalence and improve patient life quality.

A systematic review was carried out using the RSCI and PubMed databases, with the search keywords being “mild traumatic brain injury”, “accommodative asthenopia”, “convergence disorders”, “binocular vision”, “medico-social model of health”, “biopsychosocial model of health”. A total of 188 sources were analyzed, further using systematic review filters and the authors’ knowledge of the topic. It has been established that accommodative asthenopia is the leading (40–80 % of cases) functional disorder in patients with mild traumatic brain injury (MTBI), along with concomitant disorders of convergence (32–40 %) and saccadic/pursuit eye movements (30–60 %), as well as photosensitivity (photophobia, 50–55 %). Restorative treatment of patients with functional disorders of the visual system is carried out against the background of current or previously performed traditional conservative therapy for MTBI. At the same time, foreign ophthalmologists recommend carrying out a complex of treatment and rehabilitation measures for patients with functional visual impairment after MTBI based on the use of optical (including prismatic) correction, binasal occlusion, as well as outpatient and (or) home accommodation and convergence training using special computer programs and mini simulators. In domestic ophthalmological practice, a set of specific physiotherapeutic methods for influencing the organ of vision has been tested for accommodation disorders, but this approach in relation to patients with MTBI requires study. It is advisable to carry out rehabilitation treatment in the early stages after MTBI, which generally reflects the “medical-social” model of health, which provides for the fastest possible return of the patient to everyday activities with the original (pre-illness) indicators of quality of life.

Postoperative fibrosis remains a major factor limiting the long-term success of glaucoma filtration surgery. While intraoperative application of mitomycin C (MMC) is a standard adjunct to reduce scarring, its usage parameters in Russian clinical practice show considerable variation, and a comprehensive analysis of domestic evidence is lacking.

Purpose. To perform a systematic review and meta-analysis of Russian and post-Soviet studies evaluating the impact of different MMC application regimens on postoperative intraocular pressure (IOP) dynamics.

Material and methods. A systematic search of Russian-language databases (eLIBRARY.ru) was conducted for publications from the late 20^th century to the present. Nine studies (total of 365 eyes) met the inclusion criteria. Data on MMC parameters (concentration, exposure time), IOP dynamics, and complications were extracted. Statistical analysis involved calculating mean values and pooled proportions and constructing summary graphs of IOP trends and a forest plot.

Results. The included studies utilized a wide range of MMC concentrations (0.2–0.5 mg/ml) and exposure times (2–5 min). A temporal trend towards the adoption of more standardized parameters (0.2 mg/ml for 2 min) was observed. The aggregated data confirm the high hypotensive efficacy of MMC across various surgical techniques. Analysis of complications revealed an expected safety profile; however, direct comparison of regimens was hindered by significant methodological heterogeneity among the studies.

Conclusion. The use of MMC in Russia and CIS countries is characterized by considerable variability in application techniques, despite its recognized effectiveness. These findings underscore the necessity for large-scale, standardized clinical trials to optimize protocols and enhance the level of evidence.

This article presents an analysis of the literature on the etiology, pathogenesis, histology, and clinical picture of Peters’ anomaly. Based on this data and their own experience, the authors describe the key differential diagnosis criteria and treatment strategies, provide a prognosis and recommendations for the management of patients with this severe congenital anomaly.

Artificial Intelligence (AI) is revolutionising optometry by enhancing the identification, diagnosis, and treatment of ocular illnesses. AI-powered tools can help detect age-related macular degeneration (AMD), diabetic retinopathy and glaucoma earlier and more accurately. By facilitating individualised care, lowering myopia, and expanding access to telemedicine, artificial intelligence is revolutionising the healthcare industry. AI-driven platforms are enabling improvements in disease screening and diagnostic imaging, while the rise of innovations like predictive analytics, AI-enhanced contact lenses, and smart gadgets is transforming optometric practices. Some of the issues, like data quality, algorithmic bias, and integration into clinical workflows, have not been resolved by these developments. Accessing AI technologies might be difficult due to their high costs, particularly in settings with limited resources. Even today, ethical issues like correcting prejudices and guaranteeing equal access to healthcare are important. The focus of this review is on the current applications of AI in optometry, including disease detection, diagnostic imaging, and remote care. Prospects in fields like advanced vision therapy, wearables, smart devices, big data, robotics, virtual reality, predictive analytics, and machine learning are also highlighted. It is emphasized that AI can improve clinical outcomes and close healthcare gaps.

The review presents sources that describe the changes characteristic of white cataracts, as well as methods aimed at reducing the risk of complications of surgical treatment of this type of cataract. Literature analysis was carried out using the RSCI and PubMed databases. It is noted that the term “white cataract” is predominantly foreign and in the English-language literature is used as a collective concept for various forms of mature and overripe cataracts. According to published data, white cataracts require special attention due to the high percentage of intraoperative complications. In this regard, a thorough analysis of scientific publications considering the features of this type of cataract seems to be useful for specialists in terms of increasing safety and reducing the risks of surgical treatment of white cataracts.

Despite the numerous existing surgical techniques for macular hole (MH) closure, the search for the most effective surgical approach for refractory MH is of particular interest. This article presents an analysis of the literature covering methods for refractory MH closure using a free internal limiting membrane flap, autologous retinal neuroepithelial graft, amniotic membrane, posterior and anterior lens capsule fragments, and MH hydrodissection. The anatomical and functional outcomes of these techniques are highlighted.

This narrative review summarizes current concepts of ocular surface diseases (OSD) associated with the use of decorative cosmetics, aesthetic procedures, and surgical interventions. The potential mechanisms underlying the development of dry eye disease (DED), meibomian gland dysfunction, chronic blepharoconjunctivitis, toxic-allergic reactions, eyelash abnormalities, eyelid malposition, and corneal involvement are discussed. Contemporary approaches to the diagnosis of OSD and the main therapeutic strategies for this category of patients are reviewed, including risk factor modification, differential tear replacement therapy according to the predominant pathogenic subtype of DED, anti-inflammatory and etiological treatment, restoration of meibomian gland function (including therapeutic eyelid hygiene), and surgical management of eyelid and ocular surface complications. Using the most common decorative cosmetic use and aesthetic procedures as examples (excessive mascara application, eyeliner application along the meibomian gland orifices, eyelash extensions, permanent eyelid makeup, botulinum toxin and injectable hyaluronic acid fillers, upper and lower blepharoplasty), the review discusses the diagnosis, prevention, and treatment of associated ocular surface diseases.