№1, 2020, volume 16

The purpose of the study is to investigate the optic disk and peripapillary retina parameters using SD-OCTA in people of an older age group. Material and Methods. 31 patients (62 eyes), 12 males and 19 females, mean age 57.1 ±9.6 were examined. All patients underwent SD-OCT and SD-OCTA examination (RTVue XR, Optovue), by using protocol HD Angio Disk 4.5*4.5 mm. SD-OCT and SD-OCTA were used to measure the radial peripapillary capillaries (RPC, %) and retinal nerve fiber layer thickness (RNFL, urn), rim area, disc area, cup volume. Results. Mean value of the RNFL thickness was 109.7±11.1 urn. The lower value of the RNFL thickness was observed in "Tempo Inferior" and "Tempo Superior" segments. Rim area was 1.66±0.33 mm2, disc area 1.87±0.28 mm2. The mean value of RPC density in peripapillary retina was 52.2±2.3%. The lower value of the RPC density was in "Nasal Inferior" and "Superior Nasal" segments, 48.9±3.2 and 49.9±3.1 %, respectively. Conclusion. The reference values of the optic disk and peripapillary retina parameters for senior Russian citizens, which were developed with RTVue XR Avanti (Optovue Inc., USA) device, can be used as diagnostic criteria for neuroophthalmological pathology.

The purpose of the study was to analyze corneal topography in patients with cataract after previous anterior radial keratotomy Material and Methods. A total of 118 patients (118 right eyes) with a cataract and history of previous anterior radial keratotomy were examined. The average age of patients was 55.8±6.7 years (from 41 to 72). A comprehensive ophthalmological examination was performed, including the topography of the cornea using a Pentacam HR apparatus (Oculus, Germany) with the determination of elevation points of the anterior cornea. Results. The regular post keratotomy profile was revealed in 105 patients (89%), with flattening of the cornea in the central zone by an average of -10.40±3.31 urn (from-48.40 to 12.80 urn). The wrong profile with irregular flattening zones outside the optical center was detected in 13 patients (11 %). In most cases, patients with wrong profile had surgery for retinal detachment and anti-glaucoma surgery in (61%), while in the group with the correct profile it was observed only in 17% of cases. Conclusion. Corneal topography allows to establish the pattern of the post keratotomy corneal deformation, to identify its irregular zones, and to determine features of the central optical zone. Patients within correct cornea profile were older at the time of radial keratotomy. Cornea in patients with a complicated medical history is exposed to additional bio-mechanical loads, which negatively affects keratotopography.

The clinical case demonstrates high refractive efficacy and safety of photorefraction keratectomy in final correction of residual myopia and complex myopic astigmatism after MyoRing implantation.

The purpose of the study is to determine the appropriate anterior capsulorhexis size for the best capsular bag fixation in lens subluxation using iridocapsular retractors. Material and Methods. The patients were divided into three groups: group 1 included 48 eyes, group 2-50 eyes, group 3-46 eyes. A total of 144 patients (144 eyes) had lens subluxation of the first and second degree according to Pashtaev's classification. In group 1 we performed manual capsulorhexis with the mean diameter of 5.5 mm. In group 2 the diameter was 5.0 mm, and in group 3-4.5 mm. Nuclear density was classified as that of the second and fourth degree according to Buratto's classification. All patients underwent phacoemulsification with implantation of iridocapsular retractors and capsular ring. Results. The largest share of postoperative complications at 5.6% was observed in group 2, it was at 4.0% in group 3, and at 1.3% in group 2. The postoperative visual acuity increased significantly in all groups both at discharge and one year after surgery. Intraocular pressure was normalized in all patients at discharge and one year after surgery. Conclusion. The best capsular bag fixation in lens subluxation is achieved with a 4.5 mm capsulorhexis. However, the risk of anterior capsule damage increases. A 5.0 mm capsulorhexis is the most appropriate one for the best capsular bag fixation and comfort phacoemulsification.

The purpose of the study is to estimate the functional status of central retinal zone with microperimetry method in patients with retinal pathology. Material and Methods. Microperimetry was performed on 16 patients (18 eyes) with different kinds of retinal pathology including thrombosis of central retinal vein branches, age-related macular degeneration, myopic maculopathy, lamellar macular hole, tapetoretinal degeneration, ocular albinism, central serous chorireti-nopathy, proliferative diabetic retinopathy. Mean age was 52.4 years old; male — 8, female — 8. Results. The average light sensitivity of central retinal zone was reduced in the majority of patients. The decrease in the index of retinal light sensitivity in the pattern point corresponding to fixation point did not correspond to the decrease in the best-corrected visual acuity in all cases. Central defects and depression zones topographically corresponded to pathological alterations on the eye fundus. In a patient with ocular albinism fixation was characterized as unstable, in the rest of cases we observed stable fixation. The analysis of fixation allowed receiving additional information about visual quality and the degree of visuomotor coordination in patients with retinal pathology. Conclusion. As a result of the study we showed high informativity of microperimetry for assessing central retinal zone's functional status in retinal pathology.

The purpose of the study is to analyse myopic progression in association with orthokeratological (OK) correction. Material and Methods. We studied medical histories of 416 patients (832 eyes) with mild, average and high myopia in association with OK correction. Apart from routine ophthalmic examination, all patients underwent optical biometry on the IOL-Master (Carl Zeiss) device before OK lens fitting and every year of wearing the lens (maximum 5 years). Treatment results of patients with visual acuity 0.9-1.0 and 0.7-0.8 in association with OK correction were compared separately. Results. We noted an increase in the axial length of the eye (АРА) in the majority of patients. Significant differences of the annual gradient of myopic progression were revealed: it was significantly lower in patients with visual acuity 0.9-1.0 in association with OK correction in comparison with patients with hypocorrection and visual acuity 0.7-0.8. Conclusion. In cases when OK lenses are fitted to slow down myopic progression, it is necessary to achieve full myopic correction and maximum visual acuity (0.9-1.0).

The article presents a clinical case of successful treatment of a premature baby with congenital essential esotropia. The diagnosis was made in the sixth month of life. The patient was recommended spectacle correction taking into account the parameters of ametropia and constant alternating occlusion. In connection with the subsequent increase in horizontal esodeviation and the appearance of a paretic component, a bilateral recession of the internal rectus muscle by 5 mm was carried out in combination with an injection of Botox in a volume of 2.0 IU. After the first stage of surgical treatment, a stable decrease of horizontal esodeviation and an increase of the amount of abduction were achieved. Bilateral combined weakening of medial rectus muscles (classical recession and chemorecession) allows to achieve predicted good results in cases of large strabismus angles, combined with limitation of abduction.

The purpose is to perform clinical assessment of neurodegenerative and inflammatory changes in the visual organ in patients with advanced open-angle glaucoma and to identify the relationship between the degree of neurodegenerative and inflammatory changes. Material and Methods. Prospective examination of 26 patients with advanced open-angle glaucoma and 22 patients without changes in eye hydrodynamics with determination of TGF-p and MMR-9 concentrations in lacrimal and anterior chamber aqueous humor. Results. There was a statistically significant decrease in the concentration of MMR-9 in patients with glaucoma by 1.62 times in the lacrimal fluid (p<0.01) and by 2.17 times in the anterior chamber aqueous humor (p<0.05) in comparison with the control group. There was a statistically significant inverse relationship between MMP-9 in the lacrimal and the indicator characterizing a clinical picture of inflammatory reaction of the conjunctiva (p=0.02) and direct interdependence of the concentration of MMP-9 in the lacrimal and the thickness of the nerve fiber layer (p=0.02). Conclusion. The study revealed correlations between the degree of severity of the conjunctival inflammatory response, neurodegenerative changes, and the content of MMR-9 in the lacrimal and aqueous humor of the anterior chamber of patients with open-angle glaucoma.

The purpose of the study is to analyze morphometric parameters of the optic disc, peripapillary retina and ganglion cells complex of the retinal macular area in eyes with different disc area. Material and Methods. 150 patients (294 eyes) aged 62.1 ±9.6 years old were examined (male — 69, female — 81). The eyes were divided into two groups according to the optic disc area (OD): eyes with average disc area (1.63-2.43 mm2) and eyes with small disc area (less than 1.63 mm2). Analysis of the morphometric structure of the OD, peripapillary retina and ganglion cells complex of macula was performed with Heidelberg laser retinal tomography HRT-3 and optical coherence tomography RTVue-100 (Optovue, USA). Computed perimetry of the central visual field was conducted using Carl Zeiss (USA) device with HFA30-2 software. Results. In the group of eyes with small discs according to HRT we revealed the significant difference in the OD parameters (cup area, rim area, cup/disc area) between normal eyes and eyes with preperimetric glaucoma, as well as in the group with average discs (p<0.001). We detected a significant difference of the peripapillary retina parameters (RNFL) between all stages of glaucoma, including normal limits, preperimetric and advanced stages of glaucoma in the group with small discs according to OCT. Conclusion. Both HRT and ОСТ have identical capability in early diagnosis of glaucoma, however, HRT evaluates the optic disc parameters better, while the ОСТ is preferable at peripapillar retina parameters evaluation. Preperimetric glaucoma, being the principal part of diagnosing glaucoma suspect, provides for accumulation of structural alterations of the optic disc and thus early detection of glaucoma.

The purpose of the study is to evaluate major accommodation disorders in patients with ametropy. Material and Methods. Analysis of the accommodation and hydrodynamics eye state was carried out on 235 people (235 eyes) with myopia (1 group) and 52 people (52 eyes) with hyperopia. The age of patients ranged from 18 to 35 years. Results. Accommodation disorders were observed in 82% of myopia cases; they were expressed through weakness of accommodation (49.2%), habitual excess tension of accommodation (HETA) (18.6%), and combined disorders (14.2%). Accommodation disorders were observed in 86.5% of hyperopia cases, which were expressed through accommodation weakness (51.9%), combined disorders (23.1 %), and HETA(11.5%). At myopia, ophthalmic hypertension was observed in 16.4% of cases with HETA and combined accommodation disorders. Ophthalmic hypertension was detected in 5.4% of hyperopia cases against the background of accommodation weakness. Conclusion. HETA and weakness of accommodation are more often observed with an increase in myopia degree, the rigidity values of the corneoscleral membrane and corneal hysteresis decrease. Weakness of accommodation is more often observed with an increase in the hyperopia degree, the rigidity values of the corneoscleral membrane and corneal hysteresis increase.