Purpose of the work: to study the epidemiological features of primary angle-closure glaucoma (PACG) in the constituent entities of the Russian Federation taking into account the risk factors for the development of the disease in different regions of the country. Material and methods. The analysis of the epidemiological indicators of PACG in the constituent entities of the Russian Federation was carried out: the absolute number of patients, the relative number per 100 thousands of the region’s population, the share of PACG as a percentage of all glaucoma, socio-demographic characteristics (gender, average age of disease onset), anatomical features of the eye structure as a factor in the closure of the anterior chamber angle, the frequency of an acute attack of glaucoma, as well as the principles of PACG treatment. Results. The absolute number of patients with PACG in the studied regions of the Russian Federation is 50,857 people, the relative number per 100 thousands of the population of the studied entities is 33.7, the share of PACG in all glaucoma is 8.2 %. Analysis of the indicators in the regions of the Russian Federation revealed the highest absolute number of patients with PACG in the Tyumen Region (7,829 people), St. Petersburg (7,500), Kaliningrad Region (6,117) and the Sakha Republic (Yakutia) (5,562). The relative number indicators per 100 thousand population are also higher in the Sakha Republic (Yakutia) (759.3), Kaliningrad (738) and Tyumen Regions (486.7). The share of PACG as a percentage of all glaucoma is highest in the Sakha Republic (Yakutia) (51.4 %) and Tyumen Region (22 %). PACG prevails in women (66.6 %), the average age of disease onset was 59.5. Conclusion. The obtained results, consistent with the data of numerous international studies, allow us to assess the current situation with PACG in the country for timely prevention, diagnosis and treatment of this disease.

Purpose: to study the structural and functional changes in the macular zone in patients with dry age-related macular degeneration (dAMD) according to optical coherence tomography (OCT), OCT angiography (OCTA) and visometry after the use of cascade plasma filtration. Materials and methods. A total of 63 patients (94 eyes) with intermediate-stage sAMD were randomly divided into two groups. Group 1 (main) included 34 patients (52 eyes) who underwent 4 cascade plasmafiltration (CPF) procedures on the OctoNova device using the Plasmaflo plasma filter and the Cascadeflo EC40 fractionator once a week for 1 month. Group 2 (control) included 29 patients (42 eyes) who did not receive any specific treatment. Patients of the main group underwent OCT and OCTA along with a standard ophthalmological examination before the CPF course, as well as after it (1 month from the start of observation), 6 and 12 months after treatment. Patients of the control group also underwent a similar examination at the specified times — 1, 6, 12 months from the start of follow-up. Results. According to OCT, OCTA and visometry data, positive dynamics of structural and functional indices of the macular retina are observed in patients with sAMD after CPF. At the same time, a statistically significant difference between the two groups is noted starting from the first month and persists for 12 months of follow-up, which indicates stabilization of the pathological process during the specified period. Conclusion. OCT, OCTA and visometry data demonstrate improvement of the structural and functional indices of the macular zone in patients with sAMD after the use of CPF. A decrease in the risk of disease progression to a late stage and stabilization of visual functions are noted. In our study, the positive effect of the CPF persisted for 12 months, however, obviously, the positive result of the procedure is temporary, which justifies the need for further observations to determine the optimal timing of repeated courses.

Purpose: to analyze systemic risk factors of retinal vein occlusion (RVO) in young patients. Material and methods. 23 patients with RVO aged 24–44 were enrolled in a prospective case series study. All patients underwent standard ophthalmological examination, blood pressure measurement, body mass index calculation, fasting glucose and total cholesterol test. Results. Most patients (73.91%) were diagnosed with central RVO, others (26.09%) had branch RVO. Modifiable cardiovascular risk factors were identified in 73.91% of patients. The most prevalent risk factors were overweight/obesity (60.27%) and hyperlipidemia (47.37%). Arterial hypertension, smoking and a combination of hyperlipidemia and overweight/obesity were identified in 34.78% of patients. High fasting glucose level was detected in 9.5% of patients. In four cases out of six without traditional risk factors, RVO was associated with COVID-19. One patient suffered from hereditary thrombophilia (Leiden’s mutation). Conclusion. RVO in young patients is associated with modifiable cardiovascular risk factors in 73.91% of cases. The impact of these risk factors and their combinations leads to vessels wall damage, local circulatory disturbance and hyperviscosity syndrome comprising a Virchow’s triad that underlies the pathogenesis of RVO.

The purpose was to determine the biometric characteristics of the palpebral and orbital parts of the lacrimal gland (LG) in normal individuals of different ages. Material and methods. A total of 120 healthy individuals (240 eyes) were examined, including 60 children (group 1) and 60 adults (group 2). Depending on their age, the subjects were divided into subgroups: 1A — 20 children aged 1 to 7 years, 1B — 20 children aged 7 to 13 years, 1B — 20 children aged 13 to 17 years, 2A — 20 adults aged 18 to 40 years, 2B — 20 adults aged 40 to 60 years and 2B — 20 adults aged 60 to 90 years. Ultrasound examination (US) of the LG was performed on a multifunctional device using a linear 11–18 MHz sensor in the B-scan mode at medium-low values of the signal gain (GAIN). Results. Analysis of biometric parameters of the LG showed that the sizes of the palpebral and orbital parts of the LG depend on age. The minimum sizes of the LG were noted in children in subgroup 1A. The diameter and thickness of the palpebral part were 6.49±0.50 mm and 2.20 ± 0.13 mm, respectively, while the size of the orbital part was 9.50 ± 0.44 mm. In adults, the lowest values of biometric parameters of the LG were established in subgroup 2A, amounting to 8.48 ± 0.50 mm and 2.2 ± 0.1 mm for the palpebral part and 13.47 ± 0.48 mm for the orbital part, respectively. In the older age subgroup, the highest values of the parameters of the LG orbital part were noted, the average size of which was 16.02 ± 0.15 mm. Conclusion. The normative parameters of LG sizes differ significantly in adults and children, which must be taken into account when examining patients of different ages with suspected pathological changes in the LG. The biometric characteristics of the LG revealed by ultrasound in healthy individuals can be used as echographic criteria for diagnosing LG diseases.

Purpose: to study the efficacy and safety of latanoprost/dorzolamide fixed combination Dorzoprost in primary open-angle glaucoma (POAG) as initial hypotensive treatment. Material and methods. An observational study included 30 patients (33 eyes) with moderate and advanced POAG with elevated IOP without hypotensive treatment. At the screening Dorzoprost was prescribed as a single evening instillation. The endpoints were IOP, visual acuity, MD, PSD, retinal nerve fiber layer thickness, minimal width of the neuroretinal rim, macula retinal nerve fiber layer thickness, and adverse events. The observation period was 12 weeks. IOP was measured at 1, 4 and 12 weeks. Results. After 1 week, there was a statistically significant decrease in IOP, which remained stable at 12 weeks. The average IOP decrease was 33%. Positive insufficient dynamics of visual acuity, static perimetry and optical coherence tomography parameters was registered. By the end of the observation period, in 9 cases, the appearance of mild conjunctival hyperemia was noted without an increase in the severity of signs of the “dry eye” syndrome. Conclusion. Dorzoprost demonstrated a significant hypotensive effect during initial therapy, a good safety and tolerability profile.

Purpose of this work is to study the prevalence of various chronic infections, the frequency of their reactivation and associations of microorganisms in patients with Coats' disease. Material and methods. A retrospective analysis of medical records of 30 patients (36 eyes) aged from 18 to 78 years (mean 45.6 ± 15.8 years) with Coats' disease, who were treated in the Department of Retinal and Optic Nerve Pathology of the Helmholtz National Medical Research Center of Eye Diseases in the period from 2008 to 2023. To assess the infectious status of patients by the enzyme-linked immunosorbent assay (ELISA) method on the automatic ELISA analyzer "Lazurit" (USA) with the diagnostic test systems "Vector-Best" (Koltsovo) were determined serological markers of ophthalmotropic infections: antibodies to herpes viruses — herpes simplex virus (HSV) type 1 (HSV 1), HSV type 2 (HSV 2), cytomegalovirus (CMV), Epstein — Barr virus (EBV), as well as toxoplasma gondii, toxocara canis, chlamydia trachomatis, chlamydophila pneumoniae, mycoplasma hominis, ureaplasma urealyticum. Results. Serological markers of HSV 1 reactivation were most frequently detected in patients with Coats disease (64.7%). Most patients had mixed infection with a predominance of 4 or more ophthalmotropic infection pathogens. There is a tendency for markers of HSV type 1 reactivation to predominate in men and CMV in women. In the early stages of the disease, reactivation of herpes viruses (HSV 1, HSV 2, CMV, EBV) was detected in 40% of patients, and in the late stages in 26.6%. There are known features of the interaction of the virus with host cells, which lead to stimulation of VEGF-A synthesis by several mechanisms, which eventually manifests itself in the form of vascular abnormalities, which are characteristic, perhaps, of Coats disease. Conclusion. The features of the interaction of the virus with host cells, which lead to stimulation of VEGF-A synthesis by several mechanisms, ultimately manifest themselves in vascular changes, which are possibly characteristic of Coats disease.

Purpose. To develop an algorithm for efficient and safe application of the fixed combination of levofloxacin and ketorolac (Signicef® Plus) for the prevention of infectious complications and excessive inflammatory response after phacoemulsification (PE). Materials and methods. The studу group consisted of 449 patients (500 eyes), examined on 6th and 15th day after uncomplicated PE of senile cataract. Prevention of infection and inflammation included instillations of Signicef® Plus QID over five days and 0.1 % solution of fluorometholone (Floace Mono) QID for two weeks since the day of the operation. Primary outcome — proportion of patients with zero inflammatory response in the anterior segment, secondary outcomes — incidence of acute endophthalmitis, ocular surface condition and tolerance of the fixed combination. Results. Among the studied patients there were no cases of acute iridocyclitis or endophthalmitis. No inflammatory response on the 6th and the 15th day was reported in 98.8 and 100 % of cases respectively. The fixed combination was well tolerated without having a negative effect on the ocular surface. Conclusions. The use of Signicef® Plus for five days and Floace Mono for two weeks appears to be an effective and safe tool for preventing infectious and inflammatory complications of PE.

Epithelial-stromal dystrophies (ESD) are bilateral, genetically determined, progressive corneal diseases, in all cases accompanied by destruction of the Bowman’s layer. The operation of first choice is superficial keratectomy, but the risk of recurrence is always high. Purpose of the work: to evaluate the effectiveness of Bowman’s layer transplantation in the complex treatment of Reis — Bücklers and Thiel — Behnke dystrophies. Material and methods. The study is pilot, limited, prospective, monocentric. Four eyes of three patients aged 32 ± 9 years with primary and recurrent ESD were operated on. The follow-up period was 24 months. The examination included biomicroscopy, visometry, keratanalysis, optical coherence tomography of the cornea. The surgical technique included excimer laser ablation, mitomycin C application and Bowman’s layer transplantation. Complications, best-corrected visual acuity, corneal transparency, and relapse rate were assessed. Results. There were no intraoperative or postoperative complications. No signs of relapse were noted within 24 months, the cornea and transplant remained transparent. The average best-corrected visual acuity increased from 0.1 ± 0.1 to 0.5 ± 0.1, the average central corneal thickness after 24 months was 545 ± 44 μm. Conclusion. Bowman’s layer transplantation in the complex treatment of Reis — Bücklers and Thiel — Behnke dystrophies makes it possible to easily restore the anatomy of the anterior corneal surface after laser ablation and avoid significant corneal thinning. The technique is simple, ensures restoration of corneal transparency and the absence of relapses within the available observation periods, and does not increase the need for donor tissue. For greater objectivity, it is necessary to increase the number of clinical cases and observation periods.

Purpose of the work: comparative evaluation of the effect of isolated optical (OT) and combined optical-pharmacological (OPT) therapy in patients with myopia on various accommodation parameters and its stability. Material and methods. Objective parameters and stability of accommodation after OT and OFT were determined in 31 patients aged 8–13 years with acquired myopia from –0.87 to –5.75 (on average –2.96 ± 1.60) D. Patients in the OFT group used HAL (Stellest™) spectacle lenses in combination with instillations of Mydrimax solution (Phenylephrine 5.0 % + Tropicamide 0.8 %). Patients in the OT group received isolated optical therapy. Dynamic computer accommodation was performed using a WAM-5500 (Grand Seiko, Japan) with recording of the dynamic monocular accommodation response (dyn MAR) for 10 sec with a recording frequency of at least 6 Hz. The frequency of microfluctuations (FMF) of the accommodative response (AR), the maximum AR range, and the character of the signal isoline trend during the recording period were also estimated. The AR value and the coefficient of microfluctuations (CMF) were recorded using an Acomoref 2 K-2 automatic ref-keratometer (Righton). Additionally, differences in subgroups with different levels of dyn MAR stability were estimated: downward, upward, and constant MAR trend. Results. Continuous wearing of glasses with HAL lenses with full myopia correction leads to a reliable increase in the static and maximum dyn MAR. The lowest values of the average dynamic MAR are associated with a downward trend, which confirms the specificity of the “AO trend” criterion in diagnosing accommodation instability. Due to OFT, an increase in accommodation stability was noted — the AO trend acquired a constant character. In the OT group, such favorable changes were not noted. An increase in the AO value due OT and OFT was accompanied by an increase in the FMF and AO range. Conclusion. The combination of OT with regular instillations of the Midrimax increases the effectiveness of treatment of accommodation disorders in children with progressive myopia.

Purpose. Mobile phone usage is widespread in the digital age, potentially affecting eye health. This study aims to evaluate the effect of mobile screen exposure to different wavelengths, along with induced myopic and hyperopic defocus. Material and methods. A pre- and post-test quasi-experimental research of 50 emmetropic undergraduate students with a mean age of 20.68 ± 0.98 years were performed at the Pakistan Institute of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, Punjab, Pakistan, utilizing non-probability judgmental sampling. Those without ocular or general health issues and no significant refractive error on retinoscopy were included. Axial length (AL) was measured using the IOL Master 800 after thorough eye and visual examinations. An Android mobile application “Flash Screen” exposed participants to violet, blue, yellow, white, green, and red light. Myopic defocus was induced using +3.00 D lenses and hyperopic defocus with -3.00 D lenses. Jaffery Amazing Statistical Package (JASP) analyzed data. Results. Baseline axial length (AL BL) was 23.235 ± 0.657 mm. AL changed significantly after exposure to violet, blue, yellow, white, green, and red light with and without induced myopic (MD) and hyperopic (HD) defocus. Significant AL decreases (p < 0.001) were seen under violet and blue light settings, with an effect size (ES) at 1.000. Under hyperopic defocus, green and red light revealed considerable alterations (p < 0.001), with significant negative impacts. Yellow light barely changed AL. Conclusion. Emmetropes exhibit AL changes to different wavelength as per longitudinal chromatic aberrations, and dominate optical defocus effect.

Purpose: to evaluate the effectiveness of various therapeutic approaches to the treatment of seasonal allergic blepharoconjunctivitis (SABC) in patients with dry eye syndrome (DES) and meibomian gland dysfunction (MGD). Material and methods. 80 patients with SABC, DES and MGD were examined; 1^st-group patients (40 people) received 0.1% olopatodine hydrochloride (2 times a day, 5 weeks), 0.18% sodium hyaluronate (3 times a day, from the 8^th day of therapy, 4 weeks) instillations and eyelid hygiene (EH, 2 times a day) — Blefarogel cleansing (5 weeks), Blefarogel-1 (from the 8th day of treatment); 2^nd group patients only antiallergic and tear replacement therapy were prescribed. The integral indicators of the conjunctiva and eyelids objective state (C-OS; E-OS), the proportion of MGD and patients with lipid deficiency (LD), OSDI, tear film breakup time (TBUT), the lower tear meniscus heigh (LTMH) and Bijsterveld’s xerosis index (XI) were evaluated before and after therapy. Results. Patients in both groups showed C-OS, E-OS, OSDI, TBUT and XI significant positive changes as a result of therapy. In 1st group patients E-OS, OSDI, TBUT and XI dynamics were significantly more pronounced. Conclusion. In SABC patients in DE and MGD conditions, the approach that included EH in addition to antiallergic and tear replacement therapy turned out to be more effective in influencing the condition of the ocular surface (EOS, OSDI, TBUT, XI), in comparison with the approach based on antiallergic treatment and tear replacement only, which was, probably, associated with a significant decrease in the proportion of MGD and LD as the EH result.

Paraneoplastic syndromes are clinical and laboratory manifestations of the tumor process. Purpose: to study structural changes in domestic animals (cats) as a model for the development of malignant neoplasms of various origins and localizations based on histopathological analysis of the eyeballs. Material and methods. Histopathological analysis of the eyeballs of 19 cats was performed after bilateral and unilateral enucleation. The experimental group of animals included 12 cats with concomitant oncological diseases: mostly of unspecified morphology (50.0% of cases), in the control group (7 cats) there was no history of oncological diseases. Results. Histological changes in the eyeballs were detected in 36.8% of cats. Histologically significant findings were detected only in the iris of the cats in the experimental group and in the cornea of the control group. The most sensitive of the eyeball structures in the study was the iris. In 16.7% of cats in the experimental group, ophthalmologic syndrome in the form of iris cysts, which developed against the background of oncological diseases, was histologically confirmed. In the etiology of extraocular neoplasms, lymphomas and melanomas were detected to a greater extent — 16.7% each, sarcomas and squamous cell carcinoma — 8.3% of cases. The greatest cancer damage was noted in the sensory organs — 25.0%; mammary gland, lymph nodes, intestines and chest cavity — 16.7% of cases; liver, oral cavity, bladder — 8.3% of cases in the sample. In 21.18% of cases, lesions of two or more organs were established. In 21.1%, histopathological studies made or clarified an oncological diagnosis: melanoma, lymphoma. Conclusion. The study of cytoarchitecture and morphofunctional parameters of the visual organ in the aspect of malignant neoplasm development allows not only to confirm the presence of a tumor, but also to clarify its variant and individual characteristics, which determines the treatment regimen.

Purpose: to study different platelet preparations' impact on collagenase activity in vitro. Materials and methods. Human amnion transplants and collagen covers, based on human type 1 collagen, were used as collagen matrices. The drug Fermencol was used as a source of collagen-lytic peptidases. We used platelet-rich plasma (PRP); concentrated suspension of platelets washed from plasma (WP); platelet-poor plasma (PPP); lysates of PRP, PPP and WP. To assess the collagen-lytic activity we studied the level of collagen autofluorescence in tissue grafts, collagen concentration in solution, proliferation intensity of mesenchymal multipotent stromal cells (MMSC) on the surface of the grafts. Results. Preparations based on PRP and WP stimulated significant inhibition of collagen-lytic activity, which was absent in PPP. The inhibition of collagen-lytic effect in PRP and WP depended on the initial content of platelets with granules. Platelet preparations significantly enhanced the adhesion and growth of MMSC on the surface of the amnion and collagen cover. Conclusion. The use of platelet lysates combined high inhibition of collagen-lytic peptidases and growth-stimulating effect, which persists even with dilution of PRP lysate in ratio 1:200. For effective inhibition of collagen-lytic peptidases is recommended to use PRP with initial concentration of platelets with granules at least 350 thousand/ml.

The sensory nerves that are accountable for the sensation of the cornea originate from the ophthalmic division of the trigeminal ganglion. Around 20% of the nociceptors present in the cornea serve a vital function in transmitting intense and sharp pain sensations when there is mechanical contact with the ocular surface. Roughly 70 percent of the nociceptors present in the cornea respond to different chemical stimuli, such as acetylcholine, prostaglandins, and bradykinin, as well as heat and mechanical irritants. The rest of the receptors are sensitive to temperature. Most of the patients who have cornea pathological conditions complain of photophobia as one of the clinical signs. Photophobia is characterized by an elevated sensitivity of the eye to light in contrast to its usual reaction. Given that light is composed of various wavelengths, each containing a certain amount of thermal radiation energy, the term “thermophobia” might be a more suitable descriptor than photophobia. This paper presents novel findings on the perception of photophobia in cornea inflammatory conditions. It thoroughly explores the proposed neural pathway of photophobia in various neurological and eye medical conditions, shedding light on the potential underlying causes for patients experiencing photophobia, even when the exact cause remains undetermined.

Rosacea is a chronic inflammatory disease that can manifest itself with various clinical symptoms. It is mainly a skin disease, but the eyes, including the eyelids, cornea and conjunctiva, can also be affected. Due to the variety of clinical manifestations of rosacea, including ocular forms, varying severity of the pathological process, as well as insufficient understanding of its etiology and pathogenesis, there are currently no universal treatment regimens. The purpose of the work is to substantiate a multidisciplinary approach to the treatment of this disease. Material and methods. This article considers the role of the Demodex mite in the development of the disease, various variants of its clinical manifestation, approaches to treatment, and two clinical cases. Results. The main treatment includes the use of both systemic and local drugs. In the treatment of ocular forms of the disease, in addition to systemic treatment, local agents are used, such as artificial tears, anti-inflammatory drugs and immunosuppressants. In cases of severe corneal damage, various types of keratoplasty may be required. Conclusion. To determine the most effective treatment strategy for cutaneous and ocular rosacea, collaboration between ophthalmologists and dermatologists is necessary.

There is a tendency for the prevalence of mental disorders to increase among people of different age. A patient taking psychotropic and other medications can see a doctor of any profile. This article presents a clinical case where treatment received in connection with a psychoemotional disorder led to the development of an undesirable reaction from the accommodative apparatus of the eyes, which led the patient to an ophthalmologist. In the presented case, a young patient suffered from sharply decreased near vision, while taking antipsychotics, antidepressants and anticholinergics with antiparkinsonian action. Based on the complaints, anamnesis and the results of an ophthalmological examination, a diagnosis was made: paresis of accommodation of both eyes; complex hypermetropic astigmatism. The development of accommodation disturbance was considered as a side effect of taking the central anticholinergic blocker biperiden, so it was recommended to consult with her psychiatrist about adjusting the therapy. At the follow-up visit a month later, the patient noted complete restoration of near vision. The restoration of accommodation can be explained by the cessation of the anticholinergic effect due to the abolition of biperiden. The described case shows the relevance of a thorough history taking, including a history of treatment of concomitant diseases and disorders, in patients of any age.

Wegener’s granulomatosis (WG) or granulomatosis with polyangiitis is a primary systemic necrotizing vasculitis of small and medium-sized vessels with the development of foci of granulomatous inflammation. This is a severe, progressive, presumably autoimmune disease associated with antineutrophil cytoplasmic antibodies, which is detected mainly in people over 50 years of age. In the absence of timely treatment — immunosuppressive therapy (steroids and cytostatics to suppress disease activity, maintain remission and treat relapses), it can lead to the death of the patient. In the WG clinic, it begins with symptoms characteristic for respiratory infection, the lesions of the upper respiratory tract (rhinitis, nasopharyngitis, etc.), eyes, lungs (fibrosis, pleurisy, etc.) and kidneys (glomerulonephritis) prevail. One of the organs that are quite often (in about half of patients) affected by this disease, and, mainly, already in the early stages is the eye. With its defeat, in some cases, WG can even begin, but more and more often the eye is involved against the background of the development and long-term course of the inflammatory process of the upper respiratory tract and/or the first developed purulent inflammation of the middle ear in adult patients and nasal sinuses. In WG, any part of the eye can be affected, most often the anterior (most often scleritis, keratitis, less often — a corneal ulcer, etc.) and much less often — the posterior, and both in the form of a slight inflammation of the membranes of the eye to severe involvement of all its structures and orbit (pseudotumor ) with the occurrence of low vision and even complete blindness. Difficulties in the diagnosis of WG usually arise due to the variety of forms and variants of the clinical course in the early stages of the disease, when ophthalmic changes are still of little specificity, and systemic ones are practically absent. Our clinical case of WG in a 62-year-old patient indicates that the diagnosis of this disease is far from simple and takes a very long period of time. Although the presence of episleritis/scleritis with a refractory course of the pathological process, especially if the patient had a history of bilateral purulent otitis media suffered by the patient and an infiltrate in the lungs, regarded, despite the biopsy during the first analysis, as a manifestation of atypical pneumonia, should already have alerted doctors to regarding the diagnosis of WG. Unfortunately, only severe dysphagia prompted the patient to be urgently hospitalized, to examine her as much as possible with a second revision of the previously taken lung biopsy material and to make the right decision in favor of the diagnosis of WG with the appointment of subsequent adequate treatment.

Clinical picture of the “uveitis — glaucoma — hyphema” syndrome is characterized by a variety of symptoms and a wide range of their frequency due to numerous variants of the interaction between the intraocular lens (IOL) and the posterior surface of the iris, as well as the ciliary body processes. The presented clinical case of the “uveitis — glaucoma — hyphema” syndrome occurred in a patient under 70 years of age, with a blurred clinical picture manifesting as episodes of vision “clouding” over a period of 6 months, culminating in the emergence of myopic refraction and astigmatism, followed by an increase in intraocular pressure against the backdrop of worsening ametropia.

The purpose of the work is to study the genetic features of myopia manifestation according to modern data of domestic and foreign literature. The analysis of recent publications on the issues of myopia genetics is presented. The review is performed using the keywords of this topic in the PubMed, Scopus, eLibrary.ru databases. Myopia is a complex condition with many genetic variants of development both according to the Mendelian type of inheritance and as a complex disease caused by the joint contribution of several polymorphic genes that interact or act independently. It is necessary to conduct further genetic studies in various regions of our country and abroad for the development of possible individual approaches to the treatment of myopia with the choice of the age of treatment initiation, as well as to the prevention of its occurrence and progression.

Choroidal melanoma is the most common and highly malignant intraocular tumor due to its tendency to hematogenous metastasis. In the vast majority of cases, the liver is affected. Metastases in uveal melanoma (UM) develop in half of patients on average within 4.4 years after treatment. Currently, single drugs are appearing that can be used for adjuvant therapy of metastatic UM, but these drugs show limited efficacy. Until now, the only radical method of treating metastatic disease in UM is surgical destruction of single metastases in the liver. The review considers the possibility of determining circulating tumor DNA as a highly specific, sensitive, accessible and non-invasive method for diagnosing and monitoring the treatment of oncological diseases. Circulating tumor DNA can be one of the prognostic signs of UM, which helps to form high-risk groups of early metastasis for a personalized approach to the frequency of radiation diagnostic methods and detection of single metastases in the liver. With the emergence of effective methods of systemic drug therapy for metastatic UM, circulating tumor DNA can be used to monitor the effectiveness of treatment. The study of circulating DNA also allows us to determine the mutational features of the primary tumor, which in turn can be used for the differential diagnosis of primary UM and other tumors of the choroid, including metastases of cutaneous melanoma to the choroid. The review considers the possibility of using circulating tumor DNA in UM as a prognostic factor and diagnostic tool, as well as a method for assessing the effectiveness of therapy for metastatic UM.

Micropulse cyclophotocoagulation (MPCPC) is a relatively new method of laser treatment of glaucoma, which has actively entered clinical practice due to its effectiveness, relative safety, technical simplicity of implementation and speed of training. The first part of the review presents the history, mechanisms of action and protocol for performing MPCPC [ROJ. 2024; 17 (4): 111–115]. The second part of the review is devoted to the place of MPCPC in the stepwise paradigm of glaucoma treatment, including in patients with high visual acuity. An analysis of existing publications on the possibility of using MPCPC in patients with combined pathology and in children is also presented.

Surgical treatment of glaucoma is a common method of intraocular pressure normalizing when other treatment methods are not effective enough. However, hypotensive intervention does not guarantee a stable hypotensive effect, which is due to the processes of excessive scarring with difficulty in the outflow of intraocular fluid in the area of antiglaucoma surgery. When choosing the tactics of surgical treatment and methods of postoperative management, risk factors for the development of excessive scarring should be taken into account. Among them are the young age of patients, race, high initial intraocular pressure, long-term use of local hypotensive therapy, the presence of inflammatory pathology, previous hypotensive intervention and / or intraocular surgery, neovascular glaucoma, diabetes mellitus.

A systematic review was performed using the RSCI and PubMed databases, with the following search keywords: “accommodation”, “asthenopia”, “computer vision syndrome”, “quality of life”, “visual performance”. The sources were selected according to the criteria of prospective or retrospective studies. A total of 614 sources were analyzed with further use of the systematic review filters and the authors’ knowledge on the topic. To date, the following main patterns of diagnosing accommodative asthenopia (AA) in patients with visually-strained work (VSW): criteria related to objective (accommodography), subjective (quality of life), and ophthalmo-ergonomic parameters of the visual system; a personalized approach to AA diagnostics, considering habitual excess accommodation tension (HEAT) and asthenic form of accommodative asthenopia (AFAA) as separate functional disorders; a comprehensive approach to AA diagnostics, considering the occurrence of this disorder in combination with functional disorders of psychological adaptation, which are associated with the stressful nature of professional activity. Along with this, the following patterns of therapeutic and preventive measures for patients with VSW with AA phenomena are determined: the leading place is occupied by the effect of low-energy laser radiation and magnetophoresis, as well as optical-reflex training. The basis for adequate AA treatment is to determine the form of this functional disorder (PINA or AFAA). The choice of restorative treatment is based on the proposed methodological principles (personalization, complexity, consistency, standardization, repeatability), as well as time and amplitude parameters of the impact of physical factors on the accommodative system of the eye. To improve the effectiveness of restorative treatment of accommodative disorders in individuals with VSW with AA phenomena, a multidisciplinary syndrome-pathogenetic approach to the use of physical methods is necessary.

Latanoprost/timolol fixed combination (FCLT) provides clinically significant IOP reduction with a favorable tolerability profile in patients with glaucoma and ocular hypertension inadequately controlled on monotherapy. FCLT provides better IOP control compared to its components, while demonstrating a favorable safety and tolerability profile. FCLT as a single dose evening instillation provides better 24-hour IOP control. FCLT is associated with fewer side effects, more convenient dosing, and lower exposure to preservatives. These advantages have a positive impact on quality of life, compliance, and possibly on the future outcome of glaucoma surgery.

Review presents the analysis of literature data about metabolic changes in tear fluid (TF) of patients with glaucoma. Data for mass-spectrometry of TF proteome, cytokine profile, neurotrophic factors, proteinases and their inhibitors, extracellular vesicles, miRNA, catecholamines, endothelins are presented. Changes of some of these metabolic parameters outpace clinical manifestation of glaucoma and thus may have prognostic value. TF composition vary depending on the glaucoma stage. The anti-glaucomatous therapy also has influence on the TF composition due to the preservatives in the hypotensive formulations and drug substances themselves via different pathways. TF analyses can be used for the personal therapy adjustment. Data concerning the difference of TF composition in primary open-angle glaucoma and pseudoexfoliative glaucoma confirm the difference of their pathogenesis. Pseudoexfoliative syndrome with glaucoma and without one are also characterized by different alternations in TF. The data presented confirm the diagnostic value of TF as a source of biomarkers for the prognosis of glaucoma development and for the personal therapy adjustment.