№2, 2021, volume 17

Purpose: to determine the effect of a peptides solution on the processes of pathological angiogenesis in a model of post-burn neovascular albugo of the rat cornea. Material and Methods. The study was carried out at 24 rats (48 eyes). Post-burn neovascular albugo was treated after 30 days of the formation of a chemical burn of the cornea. One eye of each animal was used as a control eye, and the other was an experimental eye. In the 1st experimental group (12 animals, 12 eyes) treatment was carried out with the total fraction of the peptide drug, in 2nd group — with a fraction of the peptide drug up to 30 kDa. Instillations of the culture medium, which is used in the production of a peptide drug, were used on control eyes. The research methods included ophthalmoscopy with photoregistration, optical coherence tomography (ОСТ) of the anterior segment of the eye, assessment of morphological changes in the corneal tissues before and after treatment. The observation period was up to 30 days. Results. Treatment of post-burn corneal albugo with a peptide drug in the experimental groups had an antiangiogenic effect. In the control group, a albugo formed, which led to a thinning of the cornea, in which there were vessels of different functional state. Conclusion. The results obtained indicate the prospects of using a peptide solution for the treatment of post-burn neovascular corneal albugo.

Purpose: to analyze the impact of the COVID-19 pandemic on the anxiety level of ophthalmologists in the Russian Federation. Material and Methods. An online survey of ophthalmologists in the Russian Federation was conducted according to the author's questionnaire, which included, in particular, 8 questions about the level of anxiety in April and October 2020. The respondents (n=582) assessed the level of personal anxiety on a 5-point scale ("very strong" — 4 points, "strong" — 3, "moderate (average)" — 2, "weak" — 1, "not at all worried" — 0). Results. Ophthalmologists have a higher level of anxiety that they will personally get sick COVID-19 in April than in October 2020 (2.13±1.27 and 1.89±1.28, p<0.05). Ophthalmologists were most worried about their family members getting sick with COVID-19 (p<0.05), in additon in April more than in October 2020 (3.01±1.07 and 2.76±1.14, p<0.05). The level of anxiety of ophthalmologists that colleagues will get sick with COVID-19 was higher in April than in October 2020 (2.25±1.11 and 2.16±1.16, p<0.05). The level of anxiety that ophthalmologists will personally infect other people COVID-19 was also higher in April than in October 2020 (2.28±1.31 and 2.10±1.29, p<0.05). Ophthalmologists were less worried about the decrease in personal financial income in April than in October 2020 (2.44±1.29 and 2.69±1.22, p<0.05). The level of anxiety that friends will get sick with COVID-19, as well as that it is more difficult to get medical care for other diseases in April, did not differ from the data for October 2020 (2.24±1.12 and 2.18±1.16 (p>0.05), 2.42±1.31 and 2.41±1.27 (p>0,05) respectively). Conclusion. The COVID-19 pandemic had a negative impact on the anxiety level of ophthalmologists in the Russian Federation.

Purpose: comparative analysis of aphakia correction by differents models of intraocular lenses when using a sili-cone tamponade of the vitreal cavity. Material and Methods. Studies were conducted on 16 eyes with aphakia and pathology of the vitreal cavity. Depending on the use of the type of intraocular lenses (IOL), all patients were divided into 2 groups. Patients of the 1st group underwent the first stage of transscleral IOL fixation. Then a 25G vitrectomy was performed with silicone oil (SO) tamponade of the vitreal cavity. Patients of the 2nd group underwent an anterior chamber IOL, iridotomy, and then vitrectomy 25G with tamponade of the vitreal cavity by SO. Results. When using anterior chamber IOL, the presence of ophthalmic hypertension was revealed in 75% of cases, which is 2.0 times higher than when using transscleral IOL fixation. In 37.5% of cases, the SO output to the anterior chamber is determined, in contrast to the group where transscleral IOL fixation was used. A higher percentage of SO migration to the anterior chamber of the eye in 2nd group is due to a violation of the anatomy of the anterior chamber barrier and the vitreal cavity. Conclusion. In patients who underwent transcleral IOL fixation, visual acuity was 2.1 times higher than in patients who had an anterior chamber IOL implanted. Transscleral fixation of the IOL can form the necessary barrier between the anterior and posterior chambers of the eye, and it is also the most physiological method of correcting aphakia.

Purpose: to assess blood supply disorders at the level of the vessels of the eyeball, intracranial vessels and verte-brobasilar basin in patients with central serous chorioretinopathy (CSC) and to compare the revealed changes with the clinical picture of the disease. Material and Methods. An ophthalmological examination of 10 patients with CSC was performed: in addition to standard methods, it included optical coherence tomography (ОСТ) of the optic nerve disc, ultrasound B-scanning of the eyeball, perineural and retrobulbar space. Four patients additionally underwent magnetic resonance imaging (MRI) of the brain and cervical spine, ultrasound Dopplerography of extra- and intracranial vessels. Results. An ОСТ of the optic nerve disc revealed an expansion of the subarachnoid space. According to the ultrasound B-scan data, patients with CSC showed a moderate expansion of the perineural space of the optic nerve and a significant expansion of the orbital vessels. The MRI showed signs of internal hydrocephalus. Based on ultrasound Dopplerography of extra- and intracranial vessels, a conclusion was made about the signs of intracranial venous hypertension. Conclusion. Disorders of blood flow in the eye veins, vertebral arteries, along the transverse sinuses were revealed, signs of external and internal hydrocephalus were found. The role of pathological changes of central genesis in the development of CSC has been established. Interdisciplinary research and extended therapeutic measures are required.

Purpose: to evaluate the effectiveness of combined ranibizumab and sulodexide use in treatment of macular edema (ME) cause by retinal vein occlusion (RVO). Material and Methods. During the study, we examined 40 patients with ME cause by RVO, not exceeding 1.5 months ago. All patients underwent standard ophthalmological examination, optical coherence tomography (ОСТ), ОСТ angiography and electrophysiological studies. To evaluate the effectiveness of the combined use of ranibizumab and sulodexide, all patients were divided into two groups. In patients of the first group (n=21), the first intravitreal injection of ranibizumab was supplemented with a course of sulodexide. Patients of the second group (n=19) did not receive sulodexide. Results. The degree of improvement in eye functions in patients of the first group, who received sulodexide in complex treatment, is due to the best level of restoration of the retinal microcir-culation in the macula due to increase in the capillary network density in the superficial and deep capillary plexus in the retina by more than 1.2 times and decrease foveal avascularzone area in 1.5 times in comparison with the initial state. Conclusion. The results of the study showed the high efficiency of the combined use of ranibizumab and sulodexide in the treatment of ME cause by RVO and allow to recommend their use to improve hemomicrocirculation in the macular retina and enhance visual functions.

Purpose of the study is to evaluate the effect of orthokeratological lenses (OKL) on the biomechanical properties of the cornea in patients with myopia. Material and Methods. A clinical and functional examination was carried out in 34 patients with myopia (34 eyes), for whom OKL was selected. The study of the indicators of the biomechanical properties of the cornea was carried out on a Pentacam HR and Corvis ST device (Germany). Results. After a month of using OKL, there was a decreased corneal applanation (Applanation Velocity 1) (t=2.5, p<0.05), IOP (lOPnct and ЫОР) (p<0.05), and an increase in the amplitude of deformation (Deform. Amplitude) (t=2.14, p<0.05), peak distance of corneal flattening (Peak Distance) (t=2.43, p<0.05) with their subsequent recovery after 3-6 months. There was no change in the stresses-deformations (SSI), corneal stiffness (SP-A1), biomechanical index (CBI) during the entire observation period (p>0.05). Conclusion. The use of OKL after a month leads to a decrease in the viscoelastic properties of the cornea (Applanation Velocity 1, Deform. Amplitude, Peak Distance). At the same time, the use of OKL does not reduce the rigidity of the cornea, as evidenced by the stable indicators of SP-A1, SSI, CBI.

Objective: to analyze the interaction of the vitamin D receptor (VDR) gene alleles in patients with myopia for use in its personalized early diagnosis and prevention. Material and Methods. The total sample of the study consisted of DNA samples of 226 people living on the territory of the Russian Federation. The control sample included 103 people: 45 men (43%) and 58 women (56%) with initial emmetropia (PZO length is 22.4-24.2 mm). DNA from venous blood was isolated according to С Mathew by the phenol-chloroform extraction method. Genotyping was performed using the KASP™ Real-time, PCR method. Results. For the first time, the study of the combined effect of four alleles of the VDR gene on the functioning of various structures of the ocular apparatus, the violation of which can lead to the development of myopia, was carried out. Haplotype analysis revealed a protective combination of alleles b/b (rs1544410, Bsml) and T/T (rs2228570, Fok1) of the VDR gene, which provides normal synthesis of sclera collagen (p=0.03, x2 =4.51). Conclusion. Haplotypes B/B (rs1544410, Bsml) C/C (rs2228570) and B/b (rs1544410, Bsml) C/C (rs2228570) in the VDR gene were identified, which characterize the development of complicated myopia and can be used as diagnostic markers for early detection of predisposition to myopia and predictive and preventive measures.

With strabismology development, issues related to nascency mechanisms of various types of diplopia are becoming increasingly urgent. Of particular interest is the "non-standard" diplopia type — binocular triplopia. Therefore, a comprehensive study of the various aspects of this form of pathology is required. The review is devoted to the role of abnormal retinal correspondence in the mechanism of formation of binocular triplopia and methods of correction of this pathology. Modern generalized data on the functional features of the occurrence of binocular triplopia provide the basis for a holistic understanding of the possibility of optimizing approaches to the treatment of strabismus and achieving positive functional results. The search for information on the Internet was used to find, select, obtain information and synthesize data (Google Scholar, PubMed and eLibrary). Number of sources: 27 (from 1904 to 2020).

Objective: to analyze the effectiveness of remote diagnostics of the visual organ under circumstances of the COVID-19 pandemic. Material and Methods. A hardware and software complex for digital biomicroscopy of the anterior segment of the eye has been developed. It is a compact, stand-alone device that provides the ability to obtain digital images of the front segment of the eye under standardized lighting conditions, primary processing of the received data and their sending through wireless communication channels. For this, a Wi-Fi router and a 3G router are used. The program part is implemented in the form of a multifunctional site, which has the following sections: ophthalmic care, analysis of the received data and making medical decisions. After fixing the orbital part of the face of the subject with elastic obturators, the lighting system is turned on and the illumination mode is selected: it is possible to use balanced white light, or the use of a red, blue, green light source. An infrared study is possible. Dimming of the room is not required during the study. In a remote use case, the Internet is connected, digital data transmission and voice communication are provided. Results. Remote use of the complex in pandemic conditions allowed a primary assessment of visual organs state of 120 patients with various ophthalmic diseases. A voice channel was used to communicate with the patient. Conclusion. The developed technique, and hardware and software complex provide an opportunity to reduce the risk of spreading infection while maintaining a high level of visual organ diagnostics.

Purpose: to evaluate the effectiveness and long-term results of using autologous conditioned plasma in the surgery of complex vitreoretinal pathology. Material and Methods. Since 2018, more than 250 patients with various vitreal pa- thologies of the posterior eye segment have been operated. The developed technology made it possible to completely eliminate the need for laser coagulation of the retina, to minimize silicone tamponade of the vitreal cavity. A method of seamless sealing of sclerotomies and conjunctivotomies by autologous conditioned plasma has been developed and successfully applied. Results. Complete adhesion of the retina and sealing of defects in the structures of the eye after using autologous conditioned plasma were observed in all patients. In the long-term follow-up period up to 28 months, there were isolated recurrences of retinal detachment due to the progression of proliferative vitreoretinopathy More than 89% of patients had no complications in the long-term period. Complete closure of the sclerotomies and conjunctivotomies without the use of additional suture fixation had been achieved. Conclusion. The use of autologous conditioned plasma is an effective and safe method of sealing defects of the retina, choroid, sclera in complex open eye injury, in rhegmatogenous retinal detachment surgery, in surgery of cicatricial stage of subretinal neovascular membrane, allowing to completely eliminate the need for laser coagulation.