Acute retinal pigment epitheliitis is a rare idiopathic inflammatory disease of the retina that occurs most often in young healthy patients. The article presents three clinical cases with the results of dynamic observations.

This article presents a clinical case of bilateral ophthalmic hypertensin a patient at the presbyopic age with cysts of iridocyliary processes. A bilateral lentectomy was carried out with the implant of multifocal IOLs for refractive purposes. To evaluate the clinico-functional performance of the treatment, an ultrasound biopsy of the anterior segment of the eye was performed and a hydrodynamic assessment was carried out before and after the operation. The remote results of the treatment allow to conclude that timely extraction of native lens can significantly reduce the risk of open-closure glaucoma in patients with cysts of iridocyliary processes.

Objective: To consider new approaches to crosslinking in combination with refractive keratomodeling in corneal ectasia of various etiologies.

Methods: The work is based on clinical observations of the immediate and remote results of prophylactic and therapeutic corneal crosslinking with argon-fluorine excimer laser radiation (over 700 operations) over periods from 1 month to 13 years. Particular emphasis was placed on the formation of a Bowman-like membrane structure on the ablation surface and local exposure with a personalized gradient refractive profile of the total dose of radiation to achieve a greater keratomodeling effect. Rapid transition without additional calibrations to energy densities below the ablation threshold was carried out on the Russian excimer laser “Microscan Visum-500”.

Results: Experimental and clinical studies have shown that excimer laser radiation on argon-fluorine can be used for corneal crosslinking, with energy densities in the pulse being below the ablation threshold. The advantage of excimer laser crosslinking was scanning with a narrow beam, which disrupts the oxygenation of the corneal stroma to a lesser extent and allows for the implementation of personalized local refractive keratomodeling based on keratotopography or aberrometry data. In this case, the induced secondary radiation covers all four peaks of maximum absorption by riboflavin. The use of subablative energy densities during irradiation of the cornea in the personalized PRK mode made it possible to locally affect the ectasia zone and enhance the refractive effect due to the gradient distribution of the total radiation dose.

Conclusion: Radiation from an argon-fluorine excimer laser opens up new possibilities for refractive ablative and non-ablative refractive keratomodeling of the cornea in combination with laser-induced crosslinking in keratoconus and secondary keratoectasias of various etiologies.

Objective: to evaluate the role of ischemia in the pathogenesis of diabetic vitreopapillary traction syndrome.

Material and methods: The analysis is based on a sample of 30 patients with diabetic vitreopapillary traction syndrome. The study included a standard ophthalmological examination, color doppler mapping, fluorescent angiography. All patients underwent three-port vitrectomy to eliminate traction syndrome.

Results: The results of the obtained data indicated that patients with diabetic vitreopapillary traction syndrome had significant changes in the hemodynamics of the eye compared to the normal parameters. A significant difference in a blood flow parameters in the posterior short ciliary arteries system was recorded in eyes with vitreopapillary traction syndrome compaired to paired eyes.

Conclusion: The results of the studies indicate that patients with diabetic vitreopapillary traction syndrome have significant changes in regional hemodynamics: a decrease in blood flow velocity in the central retinal artery, posterior short ciliary arteries and an increase in peripheral vascular resistance, which indicates ischemia of the optic nerve head and may also be one of the reasons for the development of vitreopapillary traction.

Justification. Orbital fractures are one of the most common injuries of the middle zone of the face, second only to damage to the bones of the nose in adults and the lower jaw in children. An increase in the frequency of facial skeletal injuries, the complexity of diagnosis, multidisciplinary interaction, ambiguity and the lack of uniform algorithms for the treatment and rehabilitation of such patients increase interest in studying the topic of orbital fractures, require improved approaches in diagnosis and treatment.

Objective: Demonstration of a clinical case of conservative management of an inferomedial orbital fracture.

Methods. While getting off the bus, the patient tripped and hit the left side of her face on the curb. She sought medical help. A diagnosis was made: Inferomedial orbital fracture, surgical treatment was proposed. The patient refused surgery. Conservative treatment was carried out.

Results. After 3 months from the moment of diagnosis, almost complete restoration of functions and absence of aesthetic deformation was achieved. Conclusions. The optimal treatment plan is often variable and depends on the clinical situation, extent of injury, and patient comfort level.

The article outlines a diagnostic investigation following phacoemulsification of early age-related cataract in patients who exhibited no improvement in best-corrected visual acuity and reported “floating spots” in the postoperative period. Optical coherence tomography of the optic disc showed a lesion in the peripapillary nerve fiber layer, symmetrically located on the temporal side of both eyes. Computer perimetry revealed bitemporal hemianopsia. Neuroimaging (MRI with intravenous contrast) confirmed the presence of a lesion in the chiasmatic-sellar region. In this article, we present a variant of postoperative management and additional examination of a patient as an example of differential diagnostic search for a possible non-ophthalmological cause of decreased visual acuity. It demonstrates the importance of an interdisciplinary approach as a key to early diagnosis of brain tumors.

The article presents two similar clinical cases. Patients with complaints of bulbar conjunctiva neoplasm, which grew on the cornea, caused a pronounced feeling of discomfort and partially impaired visual functions, turned to the department of surgical treatment of glaucoma of the MNTC “Eye Microsurgery”. It should be noted that previously these patients underwent a sinustrabeculectomy at their place of residence in order to reduce intraocular pressure. After examination and additional instrumental research methods, the presence of a cystic filtration bleb was diagnosed and the area of anti-glaucoma surgery was revised with individual characteristics in each case. As a result of the treatment, a positive effect was achieved. At a repeat visit a month after surgery, patients did not complain, intraocular pressure was compensated, and there were no relapses.

Rhegmatogenous retinal detachment (RRD) is one of the general determinants of the primary sight disability. However, employable people represent the majority of patients with RRD.

Over the past 50 years, retinal detachment surgery had rapid progress, and the rate of success surgery increased up to 90% and higher. However, reducing the risks of reoperations, improving functional outcomes and increasing postoperative visual acuity remain topical issues at present.

The main reason for second surgical interventions is progression of the proliferative vitreoretinopathy, which can lead to epiretinal membrane, macular oedema, and to recurrence of the retinal detachment.

We reviewed current literature studies that report the results of internal limiting membrane peeling in cases with RRD and other alternative techniques aimed at reducing the risk of mentioned above postoperative complications.

Relevance. The optic nerve pit is a congenital disease manifested by a depression in the disc of the optic nerve, which affects about 0.9% of the population. Complications occur in 25–75% of patients and may include retinal detachment. The causes of detachment remain unclear, but two theories of the occurrence of this complication have been put forward. Fluorescence angiography and optical coherence tomography are used for diagnosis. The treatment of retinal detachment in ONDP is not standardized and includes laser treatment, vitrectomy and other methods for fluid drainage. It is important to differentiate ONDP from other causes of central retinal detachment.

Objective. Based on a clinical case, to demonstrate an approach to the diagnosis and treatment of local retinal detachment in the macular area associated with the fossa of the optic disc.

Materials and methods. This article presents a clinical case of retinal detachment in the macular area associated with the fossa of the optic disc. Results and discussions. When comparing two clinical cases, the similarity of the ophthalmoscopic picture and the differences in the OCT and FAG images were revealed.

Conclusions. The accumulation of fluid under the neuroepithelium is not a pathognomic sign, therefore it is important to carry out differential diagnosis in central serous retinal detachment associated with the fossa of the optic disc.

Currently, the frequency of intravitreal injections (IVV) has a steady upward trend. Antiangiogenic therapy is the predominant method of treating various retinal pathologies. Intravenous injections using pharmacological drugs against VEGF, as well as the intravitreal dexamethasone implant “Ozurdex” are widely used. Since the effect of these pharmacological drugs on cataractogenesis has not yet been sufficiently studied, research in this area is of paramount importance for understanding the morphological characteristics associated with cataract progression. Purpose: The purpose of this study is to study fluctuations in lens thickness during intravitreal administration of aflibercept and dexamethasone depot. Materials and methods. A total of 220 eyes were included in the study. Based on the administered pharmacological drug, the first group included 100 eyes that were intravenously injected with aflibercept, the second group received an intravitreal implant of dexamethasone Ozurdex, and the control (third) group included 100 eyes. Results: The dynamics of changes in lens thickness was documented in groups of patients treated with Ozurdex for 3-6 months (0.012), indicating a gradual increase in lens thickness in this group. Conclusion: no statistically significant changes in lens thickness were found in patients receiving aflibercept after 3 and 6 months. Conversely, the cohort receiving dexamethasone depot showed a statistically significant increase in lens thickness after both 3 and 6 months compared with the control group and the aflibercept cohort.

The choice of surgical treatment method for patients with refractory glaucoma of various etiologies is quite complicated. The most commonly performed surgeries are implantation of drainage devices or laser treatment methods. This article presents the results of repeated drainage surgery with Ahmed valve implantation in patients with previously implanted Ex-press shunt in patients with different types of refractory glaucoma.

Objective. To present the results of surgical treatment of patients with advanced refractory glaucoma with implantation of Ahmed valve drainage after previous implantation of Ex-Press shunt.

Methods. The study included 10 patients (10 eyes) with refractory glaucoma of various etiologies who had previously undergone Ex-Press implantation and subsequently received surgery with Ahmed valve implantation.

Results. After surgical treatment, a statistically significant decrease in the level of intraocular pressure was detected in all cases. In the early postoperative period, in one case a choroidal detachment was detected. In the early postoperative period and also during the whole period of follow-up the drainage tube was in the correct position in anterior chamber. By the 6th month of follow-up hypotensive drops were required in 5 patients.

Conclusion. At decompensation of intraocular pressure after antiglaucoma surgery with Ex-Press microshunt in patients with refractory glaucoma implantation of Ahmed valve drainage showed efficacy up to 3 years.

In modern ophthalmology, autorefkeratometry has long become a routine diagnostic study, without which it is impossible to imagine any examination. Computerized autorefkeratometers allow you to obtain a huge amount of information about the condition of the patient’s eye in a short time. At the same time, the information obtained is not always subjected to in-depth analysis.

Refractometry data should be compared with keratometry data, compared with the indicators of the paired eye, and evaluate, if possible, the dynamics of changes and their tendency. Comparison of the obtained parameters with the average statistical indicators and the age norm make it possible to establish the presence of pathology that does not belong to the field of refractive errors. Thus, the occurrence of anisometropia with similar keratometry parameters suggests opacity of the lens or vitreous pathology. Direct astigmatism is typical for young people, and oblique or reverse astigmatism is typical for patients 65+. A shift in the irido-lens diaphragm is always accompanied by a change in refraction and its instability. Keratectasias are characterized by high variability in refraction and keratometry data, while sometimes maintaining high visual acuity that does not correspond to changes in optical power. Diopter syndrome is manifested by refractive transformations in accordance with changes in the anterior-posterior axis of the eye due to retinal edema. Dry eye syndrome can be manifested by noticeable refractive instability and errors in determining keratometric parameters.

High-quality performance of autorefkeratometry, taking into account the nuances, and an in-depth analysis of the data obtained are necessary for making a diagnosis and assessing the dynamics of treatment of ocular pathology.

Vitreoretinal surgery (VRH) is recognized as the preferred method of treating diabetic macular edema (DMO), concomitant with additional pathology of the vitreomacular interface (VMI). Empirical data obtained as a result of numerous studies give contradictory results, therefore, the need for peeling of the internal limiting membrane (VPM) remains unresolved.

Purpose. To find out the results of surgical intervention in patients with DMO as a result of epimacular fibrosis (EMF) by comparing cases with and without HPV peeling.

Materials and methods. This manuscript presents a comparative assessment of three clinical cases. The patients had similar clinical manifestations and historical medical data. In all cases, patients underwent HRH for DMO combined with EMF. In two cases, the VPM was peeled, and in the third case, the VPM was preserved.

Results. An analysis of the observational data and an assessment of anatomical and functional parameters revealed complications in the first and second patients at the late postoperative stage, while in the third patient the condition stabilized. Conclusion. The presented clinical cases show that anatomical and functional results are not always correlated. The increased risk of complications associated with a violation of the architecture and functionality of the retina during peeling requires a critical assessment of the clinical justification of this method.

Anti-angiogenic injections are currently established as the «gold standard» for treating diabetic macular edema (DME). Vitreoretinal surgery is indicated in cases involving an epiretinal membrane or vitreoretinal traction syndrome. Some physicians consider it feasible to perform vitrectomy with the removal of the internal limiting membrane in patients with this condition.

The objective of this study is to assess changes in the morphofunctional parameters of the retina in patients with resistant forms of DME who have undergone surgical intervention. At the N.I. Pirogov National Medical and Surgical Center, 75 patients diagnosed with DME unresponsive to conservative therapy (anti-vascular proliferation therapy, retinal laser coagulation) were operated on. All patients were divided into three groups based on the type of intervention.

Evaluation of best-corrected visual acuity after surgery revealed a statistically significant improvement in this parameter among patients in the second and third groups compared to those in the first group six months post-operation. Patients in the third group showed a notable reduction in retinal thickness in the foveal area one month after the intervention. A significant decrease in edema was observed in patients from the second and third groups compared to those in the first group over the period from one month to one year. When assessing light sensitivity, a significant improvement in parameters was noted in patients from the second and third groups compared to the data from the first group one week after the surgery.

The results confirm the high effectiveness of vitreoretinal surgical intervention in patients with resistant diabetic macular edema, affirming the possibility of selecting a surgical approach.

Rationale: Uveal tract schwannomas are extremely rare tumors that can mimic choroidal melanoma, which makes diagnosis and treatment tactics difficult. Despite the fact that this is a benign tumor, if untimely treatment is not provided, it can reach the degree of melanoma differentiation and have extraocular growth, which changes the vital prognosis.

Objective: To present a clinical case of choroidal schwannoma, analyze the features of diagnosis and choice of treatment tactics.

Methods: Diagnostics and examinations were performed at the State Budgetary Healthcare Institution of the Nizhny Novgorod Region “City Hospital No. 35 of the Sovetsky District” of Nizhny Novgorod and included: examination of the fundus under conditions of drug-induced mydriasis, B-scanning, histological and IHC studies of the enucleated eyeball.

Results: According to the results of the morphological study, a rare tumor of the uveal tract, namely schwannoma, was obtained, which was subsequently confirmed by the performed IHC study.

Conclusion: Despite the benign nature of the tumor, its tendency to imitate uveal melanoma and the peculiarities of the clinical course (a high percentage of relapses after non-radical surgical treatment, frequent extraocular growth, pain syndrome developing due to the size and inevitable loss of visual functions), enucleation is a relevant method of surgical treatment as a treatment tactic, since all organ-preserving interventions lead to continued tumor growth.

Purpose: To evalute the efficacy of short-term tamponade of the vitreal cavity by perfluorinated compound and to analyze the morphological changes after surgical treatment of the patients with rhegmatogenous retinal detachment with rupture in the lower retinal hemisphere.

Material and methods: The analysis of surgical treatment of 31 patients with the diagnosis of primary rhegmatogenous retinal detachment in combination with proliferative vitreoretinopathy с type 1–2 with inclusion of the macular zone, with the localization of the rupture in the lower retinal hemisphere. All patients were divided into two groups depending on the tamponade vitreous cavity. I group (n = 15): first stage – vitreoretinal surgery with a tamponade of the vitreous cavity of perfluoroorganic compounds for 14 days, second stage – removal of perfluoroorganic compounds from the vitreous cavity + facoemulsification with implantation of the intraocular lens + tamponade of the natural gas mixture (С2F6). Monitoring for at least 6 months after perfluorinated compound or silicone oil removal.

Results: The preliminary results of the study showed a high effectiveness of short-term perfluorinated compound tamponade compared to the silicone oil tamponade in patients with rhegmatogenous retinal detachment with rupture in the lower hemisphere. In all 1st group patients complete retinal reattachment was achieved in all observation periods. In 2nd group, partial retinal reattachment in the lower departments in the long-term postoperative period was detected in 37.5% of cases. There was no cystic macular edema in Group 1 patients, while it occurred in Group 2 patients in 18.7%. Epiretinal fibrosis was detected in Group 1 patients in 14.3% of cases and in Group 2 patients in 31.2% of cases during the whole observation period.

Conclusion: The results of the conducted study confirm the effectiveness of the use of short-term tamponade of the vitreous cavity of perfluorinated compound in the treatment of patients with retinal detachment at the localization of a tear in the lower retinal hemisphere. This method improves the anatomical results of vitreoretinal surgery in this category of patients and helps to reduce the number of postoperative complications.

Rationale: Diseases of the cornea of the eye account for a quarter of the total incidence of ophthalmological pathologies, which, in turn, are detected in 11% of all cases of appeals. These pathologies are dangerous, since 75% of patients with this group of diseases may subsequently develop visual impairment, up to its complete loss. In case of severe lesions, surgical intervention is inevitable, while both allo- and autografts can be used for corneal flap transplantation, with the sclera being the most preferred option in this case. Autosclerokeratoplasty seems to be a modern, most rational method for treating severe pathologies of the cornea, and updating this method seems to be a very important task.

Objective: updating the method of autosclerokeratoplasty for corneal lesions using a clinical example of the successful use of the method for ulcerative lesions of the cornea.

Methods: An analytical work of scientific literature for the last 10 years was carried out, PubMed databases were used, including PubMed Central, Google Scholar, CyberLeninka. The search was conducted using the keywords “autosclerokeratoplasty”, “autosclera”, “corneal ulcer”, etc.

To characterize the possibility of using autosclerokeratoplasty in clinical practice for corneal damage, a clinical case is given, medical documentation was used for the analysis: outpatient card, medical history, instrumental and physical examination data. The data were systematized using modern methods of information analysis.

Results: The method has many advantages over other methods of surgical treatment of corneal pathologies: 1) performing anterior lamellar keratoplasty of the cornea allows to reliably close the optical zone, eliminating the threat of perforation and in some cases improve the patient’s vision, 2) in case of a threat of rejection of the lamellar keratograft, it is possible to take a second peripheral fragment of the cornea under the upper eyelid, 3) suture fixation of the autoscleral flap over the area ofthe corneal defect under the upper eyelid allows to achieve an aseptic course of the process, 4) the location of the area for taking the lamellar keratograft under the upper eyelid does not worsen the cosmetic appearance of the operated eye. Based on a clinical case with a severe patient, the potential of this operation is visible.

Conclusion: autosclerokeratoplasty is a progressive method of surgical treatment of corneal pathologies. Since the incidence of these pathologies is high, and the risk of disability is high, the actualization of this method is most important. At the same time, all the current data on the possibilities of autosclerokeratoplasty are provided based on scientific literature and a clinical case.

A method for minimally invasive correction of lagophthalmos and its complications has been developed. Subcutaneous injections of low-molecular and high-molecular sodium hyaluronate (LM-NaH and HM-NaH) forms with different concentrations of the active substance have been proposed as a new method. The experiment has proven the maximum efficiency of 2% high-molecular sodium hyaluronate in maintaining the shape and width of the palpebral fissure (the effect lasts for 4 weeks). Low-molecular sodium hyaluronate form had the best effect on the condition of the ocular surface. These properties can be explained by the large size of high-molecular sodium hyaluronate molecules and the viscosity of the preparation, which allows the substance to be retained in the thickness of the eyelids for a long time, but does not allow it to penetrate the hematophthalmic barrier. The positive results of the experiment made it possible to use this method in clinical practice for patients with lagophthalmos. To date, one patient has been treated who suffered from facial nerve neuritis with subsequent development of lagophthalmos. A combined technique was used with simultaneous use of subcutaneous injections of 2% high-molecular and subconjunctival injections of 1% low-molecular sodium hyaluronate. After three procedures with an interval of 3 weeks between them, positive dynamics were noted in the form of improved closure of the palpebral fissure, an increase in the Schirmer test, and the absence of complaints from the cornea. Thus, we can talk about the effectiveness of this minimally invasive technique for patients with lagophthalmos and its complications with a one-time impact on the maximum possible number of pathogenesis links.

FemtoLASIK is a frequently performed refractive surgery, one of the complications of which is flap dislocation. Most often, this condition is accompanied by decreased vision, pain, lacrimation, which makes patients immediately visit ophthalmologist. This article describes a case of a patient who came to the clinic only on the fourth day after the flap displacement due to blunt eye trauma. By this time, the patient’s corneal flap had significant edema, was folded and displaced with exposure of the stromal bed, which was epithelialized over 2/3 of the area. The surgical treatment of this patient with restoration of anatomical structures, as well as visual functions exceeding the maximum-corrected at the preoperative stage is presented. The treatment provided a stable result for 15 months after the performed reposition.

This paper has the purpose to analyse the relevance of the use of angiogenesis inhibitors (anti-VEGF drugs) in the treatment of the proliferative stage of diabetic retinopathy. The literature review was carried out using the search engines PubMed, the Library, and the analysis of literature sources, 30 in number, published from 2000 to 2024. In patients with complicated cases of proliferative diabetic retinopathy, pre-intravitreal injection of angiogenesis inhibitors provides the most gentle approach to surgical treatment, which improves the anatomical and functional results of vitreoretinal surgery and helps reduce the number of intra- and postoperative complications.

Usually, the recurrence rate of regmatogenic retinal detachment (ROS) after surgery ranges from 3% to 30%. In cases where the disease recurs after successful surgery, in 60% of cases the main factor is the progression of proliferative vitreoretinopathy (PVR), which makes it one of the most severe complications that can occur in the postoperative period. In addition, after removal or absorption of a tampon agent (in particular, endotamponade with silicone oil), recurrent retinal detachment may occur due to the inability to detect retinal rupture during surgery.

Objective: this study is aimed at evaluating the effectiveness of diagnostic methods used during operations for regmatogenic retinal detachment. After completing the standard stages of central vitrectomy, the group of patients was divided into two equal groups: the first group included patients who received the double contrast method, and the second group (control) – patients who underwent the traditional surgical method.

Results and discussion: in patients of the control group, there was a significant increase in the number of relapses of ROS. In addition, it was found that an increase in the number of retinal tears correlated with a greater likelihood of macular involvement; Statistical evaluation has shown that the absence of AST and tight adhesion of the posterior hyaloid membrane to the retina and small retinal tears increase the risk of recurrence of ROS due to the progression of PVR.

Today, about 537 million people in the world aged 20 to 79 suffer from diabetes mellitus, in 3% of cases neovascular glaucoma is diagnosed, threatening vision loss. Neovascular glaucoma is one of the most aggressive forms of secondary glaucomas and is often refractory to standard treatment methods. In domestic and foreign literature, there is no single standard for choosing the tactics of surgical treatment of patients with neovascular glaucoma against the background of diabetic retinopathy. In this regard, studies aimed at studying the morphofunctional parameters of eyes with neovascular glaucoma against the background of diabetic retinopathy acquire not only theoretical but also obvious practical interest. In the course of further development of methods for complex effects on eye structures to reduce intraocular pressure and progression of the glaucoma process. An analysis of optical coherence tomography images of 51 patients (51 eyes) was conducted, and the main aspects were identified for further use in choosing the tactics of surgical intervention.

Intermediate uveitis often occurs asymptomatically, and children tend to underestimate changes in vision until the first complications appear, leading to a prolonged course of the disease without treatment. The formation of opacities in the lens is one of the most common complications of uveitis in children that require surgical intervention. However, lens opacification is often considered in isolation from other changes in the eye, which in turn defines the goal of the surgery as achieving a quick functional result. At the same time, one of the complications of intermediate chronic uveitis, existing alongside cataract, is the cyclitic membrane, which is an important factor in determining the strategy for surgical treatment. This article presents a clinical case of treating complications of uveitis in a child, where the intervention strategy aimed to minimize the number of complications in the future despite the delayed functional outcome.

Rationale: In case of combined pathology, in particular aphakia and regmatogenic retinal detachment, an important point is the leveling of changes in the iridocrustal apparatus. When analyzing the morphoanatomic parameters of the angle and depth of the anterior chamber using optical coherence tomography, distinctive features were revealed in patients with various methods of correcting the defect of the iridohrustal barrier.

Objective: of the study was to evaluate anatomical changes in the angle and depth of the anterior chamber in patients with various types of intraocular correction of the defect of the capsule-binding apparatus under conditions of tamponade of the vitreal cavity with silicone oil.

Methods: Studies were conducted on 74 eyes of patients aged 56 to 75 years with various methods of correction of aphakia and silicone tamponade of the vitreal cavity.

Results: There was a significant decrease in the anterior chamber angle in various sectors in patients with aphakia, in contrast to patients with anterior chamber and transclerally fixed intraocular lenses. A similar trend is observed in patients with anterocameral intraocular lenses, relative to the group of patients with artifacia. A decrease in the depth of the anterior chamber was revealed in patients with anterior chamber lenses relative to patients with transcleral fixation and articulation was revealed in the upper sector. In the temporal sector, there is a decrease in this indicator in patients with aphakia relative to patients with artifakia.

Conclusion: In the conditions of silicone tamponade of the vitreal cavity, the technique of transcleral fixation of intraocular lenses provides the most physiological indicators of the anterior chamber angle comparable to single-format indicators of patients with artifacia.

The difficulty of diagnosing Vogt-Koyanagi-Harada syndrome is due to the fact that in the prodromal stage, the inflammatory process develops in the vascular membrane without ocular manifestations, clinically, flu-like syndrome, meningism come out in the first place, mistakenly leading the patient to a doctor of another specialty.

Objective: To analyze optical coherence tomography (OCT) data and clinical manifestations for early diagnosis and timely treatment of Vogt-Koyanagi-Harada syndrome.

Methods: Data from two clinical cases are presented: patient T. with timely pathogenetic pulse therapy and patient B. with alternative treatment due to his refusal of the proposed therapy. Results: Against the background of treatment, both patients have an increase in visual acuity, but patient B. has a less favorable prognosis according to OCT data due to the lack of adequate therapy.

Conclusion: OCT of the macular region makes it possible to make the correct diagnosis at an early date, which prevents the transition of the uveitic stage of Vogt-Koyanagi-Harada disease into a chronic one.

EDOF is the name of a new category of intraocular lenses that are a kind of compromise between traditional monofocal and trifocal IOLs. Monofocal IOLs allow you to have good vision at one distance with high quality. Multifocal, on the contrary, give sufficient visual acuity at various distances, but are characterized by the presence of a large number of dysphotopsias. Intraocular lenses with extended focus provide greater independence from glasses than monofocals while maintaining high quality vision.

Objective: to discuss the available information on the principles of EDOF imaging by lenses and the dependence of the state of the wavefront of the artiphakic eye on the combination of spherical corneal aberrations and IOLs.

The wavefront of the eye is formed by several structural elements, the main of which are the cornea and the lens (artificial lens). The study of aberrations of the human eye is in the field of refractive surgery. Attempts to use aberrations in cataract surgery began with the creation of aspherical IOLs. The latter were intended to correct spherical corneal aberrations and were aimed at improving the characteristics of the wavefront. The development and use of aspherical IOLs were based on data on the state of the cornea of the average eye and gave a conditional effect. The new generation of IOLs based on the creation of a certain number and type of spherical aberrations is designed to modify (deform) the wavefront of the artifakic eye and expand its optical capabilities while maintaining a low number of dysphotopsias. This, in a way, revolutionary change in trends brings cataract surgery even closer to refractive surgery.

According to the authors, for the fullest use of the capabilities of IOLs from the EDOF category, it is necessary to apply the principles and experience of refractive surgery in terms of studying the characteristics of the operated eye and correlating them with the parameters planned for IOL implantation.

Rationale: Age-related macular degeneration in the modern world is one of the leading problems leading to blindness. It is a rapidly progressive disease characterized by damage to the central area of the retina.

Objective: The aim of the study was to evaluate the morphological and functional parameters of the retina after surgical treatment of submacular hemorrhages against the background of anti-vasoproliferative therapy in patients with a wet form of age-related macular degeneration.

Methods: The study was conducted on the basis of the Ophthalmology Center NMHC named by Pirogov (Moscow). It included 90 participants with an active form of age-related macular degeneration. The average age of the patients was 71.3 ± 8.5 years, including 50 women aged 61 to 82 years and 40 men aged 74 to 78 years. The rationale for the use of the “treat and extend” strategy in this work is the possibility of using fewer intravitreal injections compared to a fixed scheme that gives similar results of visual functions.

Conclusion: It can be concluded that the preservation of the vitreous body during minimally invasive vitreoretinal intervention allows you to adhere to the “treat and extend” mode without reducing the inter-injection interval.

Rationale: The article discusses difficulties in the differential diagnosis of intraocular tumors (IOT), particularly in cases of small choroidal melanoma. Despite a substantial number of publications dedicated to the diagnosis of intraocular tumors, difficulties in interpreting imaging methods, such as optical coherence tomography (OCT), persist.

Objective: to analyze the OCT patterns that have led to diagnostic errors.

Methods: We analyzed the OCT results of 15 patients whose diagnosis of «choroidal hemangioma» was revised to «choroidal melanoma» in 11 cases or «progressive nevus» in 4 cases. The mean age at the time of IOT detection was 50.20±13.08 years (range: 35–79 years); the average tumor prominence was 2.22±0.82 mm (range: 1-3.6 mm), and the average diameter was 8.01±2.72 mm (range: 3.11–11.5 mm). A detailed analysis of the specific OCT patterns that led to diagnostic errors was conducted.

Results and discussion: The characteristics of the identified OCT patterns that frequently caused diagnostic difficulties were thoroughly examined, such as cystic changes and the «subretinal cleft» phenomenon. Cases in which complex OCT patterns overlapped with both melanoma and hemangioma were also analyzed, reinforcing the need for a multimodal approach to the interpretation of imaging data. Conclusion: for accurate diagnosis and to avoid erroneous planning of treatment strategies, OCT should be evaluated within the context of the clinical picture and patient history.

Background. The development of laser systems with automated control of retinal coagulation depth will make it possible to obtain reproducible laser burns of a given brightness on the ocular fundus during treatment. Nevertheless, the problem of correspondence of the brightness of the formed coagulates fixed by video capture to the depth of the formed coagulates in the retinal thickness remains poorly studied.

Objective. To study the correspondence between the brightness of the formed burns recorded by video capture and the depth of retinal coagulation during dose-dependent laser photocoagulation using an automated laser system based on the feedback principle.

Materials and methods. A prototype of an automated system for laser photocoagulation of the retina, consisting of a 0.81 µm diode laser and a video capture module integrated into the optical system of the slit lamp, as well as software that controls laser exposure using the feedback principle. Studies were performed on rabbit eyes (n=20). At spot diameter 200 µm, power 100, 140, 180, 220, 260 and 300 mW and planned coagulation levels 5, 10, 20, 30, 40, 50 and 70%, the actual brightness of the obtained coagulates (%), the correspondence between planned and actual coagulate brightness were studied. The depth of coagulation (% of neuroretina thickness) and its correlation with the actual brightness of coagulates were studied at OCT.

Results. With a planned brightness of 5-10% (grade 1 according to L’Esperance), the actual brightness of the burns was significantly higher, the depth of coagulation on OCT was 20 to 30% of the retinal thickness. At the planned brightness of 20-40% and 5-70% (grade 2 and 3 according to L’Esperance), the actual burns brightness was not significantly different throughout the power range, and the depth of coagulation by OCT was 35-50% and 80-120%, respectively. The coefficient of variation of actual brightness and coagulation depth did not exceed 15% for the whole range of planned brightness and used power, except for cases of planned brightness of 5-10% and power of 220 mW and more. A significant correlation was found between actual brightness and coagulation depth (R=0.96, p=0.001).

Conclusion. During laser coagulation of the retina using a new automated laser system based on the feedback principle, homogeneous laser coagulates are automatically formed, and there is a significant correlation between the depth of neuroretinal coagulation and the brightness of burns recorded by video capture.

New drugs and methods of early diagnosis of malignant tumors of the visual organ have appeared in the last decades. Nevertheless, the problem of untimely diagnosis and treatment of these diseases remains in practical ophthalmology, which leads to more radical and less organ-preserving methods of treatment and, as a consequence, to the deterioration of cosmetic and functional results in subsequent eye prosthetics.

Aim. To analyze and discuss the literature on the following topics: ocular prosthetics and ophthalmic oncology using available databases.

Material and methods. Optimization of domestic and foreign scientific papers using eLibrary, PubMed, ScienceDirect and Google Scholar databases.

Results. The 52 most relevant sources of domestic and foreign literature were analyzed.

Conclusions. Having analyzed the literature data in domestic and foreign sources, we can conclude that the world medical community has not fully disclosed the issue of eye prosthetics in patients after oncological treatment. More research and practical recommendations are needed in this area. The use of a staggered prosthetic method, as well as the shape of the eye prosthesis, taking into account the individual characteristics of the conjunctival cavity, will help to achieve the best results.

Diabetic retinopathy is one of the most severe complications of diabetes mellitus, requiring the participation of doctors of various specialties: endocrinologists, diabetologists, therapists, cardiologists, surgeons, anesthesiologists and others.

The task of an ophthalmologist is to identify pathological changes in the eye associated with diabetes mellitus and prescribe appropriate treatment.

There are three main methods for treating diabetic retinopathy: 

• laser coagulation of the retina;
• intravitreal injections of anti-VEGF and glucocorticoids;
• vitreoretinal surgery.

This literature review examines the use of vascular endothelial growth factor inhibitors in the treatment of diabetic retinopathy. In particular, it discusses the most relevant drugs, the most important studies on the therapy of DR and diabetic macular edema, as well as a post hoc analysis of these studies. In addition, the role of these drugs in the therapy of refractory DME is discussed.

Rationale: The effect of retinal perfusion on functional recovery of the fovea, as well as the value of quantitative perfusion parameters as predictors of functional outcome in the surgical treatment of full-thickness macular holes (FTMH) remains poorly understood.

Objective: To study the relationship between changes in retinal perfusion and functional parameters of the fovea in the postoperative period at 1 and 2 types of FTMH closure.

Methods: A prospective study including 93 patients (93 eyes) with idiopathic FTMH stage 2-4 according to D. Gass after surgical treatment. In subgroups with type 1 and type 2 of FTMH closure, changes in the foveal avascular zone (FAZ) area and vessel density in the superficial and deep capillary plexuses (SCP and DCP) in the fovea, changes in BCVA, retinal sensitivity (RS) at the fixation point, and P1 amplitude in the fovea were studied. Studies were performed preoperatively, 1 and 6 months after surgery. A significant correlation was found between the changes in BCVA, RS at the fixation point, P1 amplitude in the fovea, and changes in vessel density in the SCP and DCP, which was more pronounced in the period from 1 to 6 months after surgery. The correlation of the changes in the parameters is higher in type 2 of FTMH closure than in type 1 of FTMH closure.

Results:. Subgroups with type 1 and type 2 FTMH closure included 67 and 26 eyes, respectively. Type 2 FTMH closure showed lower vascular density in the DCP before (p=0.02) and 6 months after surgery (p=0.03), lower BCVA before surgery (p=0.03), 1 and 6 months after surgery (p <0.001), lower RS at the fixation point before and after surgery (p<0.002).

Conclusion. In type 2 macular hole closure, postoperative changes in retinal perfusion have a more pronounced impact on functional recovery of the fovea, especially in the late postoperative period.

Rationale: Macular hole is a defect of the retina in the foveolar zone. In combination with rhegmatogenous retinal detachment, this disease can lead to irreversible deterioration of visual functions and requires immediate surgical treatment. One of the trends in modern ophthalmic surgery is to increase the area of preservation of the internal limiting membrane during the macular hole blocking. Despite this, microperimetry data indicate the appearance of microscotomas at the point of peeling initiation and a general decrease in the photosensitivity of the retinal tissue in the membrane removal zone.

Objective: to analyze the dynamics of changes in the retinal functional parameters of patients with macular hole and rhegmatogenous retinal detachment according to microperimetry data after surgical treatment in the late postoperative period.

Methods: Data from 40 patients (40 eyes) diagnosed with macular hole and rhegmatogenous retinal detachment were prospectively studied. Patients in group 1 (20 patients, 20 eyes) underwent surgical treatment, including three-port 25G vitrectomy, perfluoroorganic compound, vitreous body sanitation at the periphery, and silicone tamponade. Membrane peeling was performed during the second operation to remove silicone. Patients in group 2 underwent vitrectomy, membrane staining under the perfluorine layer, membrane peeling with closure of the macular hole with an inverted flap, vitreous body sanitation during the first intervention. The operation was also completed with silicone tamponade. During the second intervention, silicone oil was removed from the vitreous cavity.

Results: When comparing the light sensitivity index of the retinal tissue in the foveolar zone between the groups, a reliable difference in the indices by 1.2 times continued to persist up to one and a half years after the final stage of surgical treatment, there was a predominance of values in patients of the 1st group with a completely preserved membrane (p = 0.043 in comparison with the data of patients of the 2nd group). In three peripheral zones of the macula, during the long-term observation period up to one and a half years after surgery, the indices of patients of the 1st group prevailed by 1.5 times (p = 0.041 in comparison with the data of patients of the 2nd group).

Conclusion: based on the analysis of the dynamics of the functional indices of the retina of patients after surgical treatment of macular hole in combination with rhegmatogenous retinal detachment, the refusal to perform membrane peeling on the detached retina during the first stage of surgical intervention allows to avoid aggressive mechanical trauma to the retinal tissue.

Relevance: currently, micropulse transscleral cyclophotocoagulation is widely used for the treatment of refractory glaucoma. It has a high safety profile and can be applied to eyes with high visual potential. Continuous-wave cyclophotocoagulation has a more pronounced hypotensive effect; however, it is accompanied by a significant number of complications. During transscleral cyclophotocoagulation, it is suggested to use a standard position for the sensor, though the position of the ciliary processes may vary.

Purpose: to analyze the effectiveness and safety of the combined cyclophotocoagulation technique using transillumination.

Materials and Methods: the study included 22 patients (22 eyes) who underwent combined cyclophotocoagulation with transillumination. The observation period was 6 months, with control examinations conducted at 1, 3, and 6 months. At each visit, refractokeratometry, visual acuity assessment, ultrasound examination (B-scan), tonometry using the Maklakov method were performed. There was one case of postoperative uveitis in the form of iridocyclitis

Results: after six months, intraocular pressure decreased by 45% from the baseline level-from 35.5 (34–38.5) mm Hg to 20 (20–21) mm Hg. The number of hypotensive therapy drops was also reduced-from 7 (5.75–7) to 4 (3.25–4) drops per day.

Conclusion: combined cyclophotocoagulation with transscleral transillumination demonstrated a stable hypotensive effect over 6 months, with no significant complications such as prolonged hypotony, phthisis bulbi, or persistent refractory uveitis, which are commonly seen with continuous-wave cyclophotocoagulation. Thus, this technique may become an effective alternative to standard methods of cyclophotocoagulation.