2021, volume 17

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.

Clinical case demonstrates the capabilities of the visual analyzer in patients of preverbal, verbal age with Treacher Collins syndrome. Attention is focused on the importance of early diagnosis and treatment.

Purpose: to evaluate the effect of changes in pupil size on visual acuity after implantation of multifocal intraocular lenses in patients with senile cataract, to assess the influence of multifocal intraocular lenses on the quality of life of elderly people. Material and Methods. 50 eyes of 50 elderly patients (32 men, 18 women aged 48-81 years) after cataract surgery in 2019-2021 were retrospectively examined. Preoperative and postoperative pupil sizes were measured using an Oasis pupillometer. We assessed the quality of life using a special questionnaire NEI-VFQ-25 (National Eye Institute Visual Function Questionnaire, version 2000), before and one month afterthe operation. Results. The average preoperative pupil size decreased to 4.1±0.9 from 4.9±1.0 mm during the first postoperative month (p=0.05). In the total score forthe quality of life the patients had an increase after surgery from 49.5±15.1 to64.7±14.4 points (p<0.05). Conclusion. The change in the pupil size after surgery does not affect or only slightly affects the clinical results of implantation of multifocal intraocular lenses (MF-IOLs). Multifocal intraocular lenses allow elderly people to improve their quality of life.

The clinical case demonstrates eye complications after chemotherapy. Patient K. complained of redness of both eyes, lacrimation, external eyelid changes, hyperemia, and dry face and forehead skin. The patient was undergoing chemotherapy for rectal cancer. Chemotherapy led to dermatitis, which was complicated by eyelid ectropion, and caused secondary dry eye syndrome. This was the result of toxic, inhibitory effects of chemotherapy on growing, fast-acting skin cells. The treatment was performed in conjunction with a dermatologist and had a positive effect. One month after treatment, skin and eye conditions improved. A clinical example has shown that chemotherapy can serve as a starting point for the formation of eyelid ectropion and the subsequent manifestation of dry eye syndrome. Patient follow-up demonstrated that a multidisciplinary approach to disease diagnosis is needed in the development of secondary dry eye syndrome.

Purpose: to identify the frequency of symptoms of viral conjunctivitis in persons with a new coronavirus infection. Material and Methods. The data of a survey of 100 patients diagnosed with "bilateral pneumonia with laboratory-confirmed polymerase chain reaction (PCR) coronavirus infection (U07.1)" were analyzed. Results. The analysis of the survey results showed the presence of symptoms of viral conjunctivitis in 53% of the 100 patients surveyed. The most common symptom was eye pain (in 29 respondents, or 54.7% of patients with symptoms of conjunctivitis). Further in descending order: blurred vision (27 respondents), eye discomfort (23 respondents), lacrimation (23 respondents), itchy eyes (21 respondents), burning eyes (19 respondents), sore eyes in bright light (15 respondents), redness of the eyes (conjunctiva and eyelids) (12 respondents), discharge from the eyes (mucous, purulent) (11 respondents), edema of the conjunctiva and eyelids (7 respondents). Conclusion. Most patients with a confirmed diagnosis of coronavirus infection have symptoms of viral conjunctivitis (53% of patients). This fact indicates the need for mandatory diagnosis, timely treatment and prevention of viral conjunctivitis in patients with a confirmed diagnosis of coronavirus infection.

The article presents the history of the organization and the main stages of the formation and development of the clinic of skin and venereal diseases of the Saratov State Medical University named after V. I. Razumovsky. The article shows the scientific and practical contribution of the clinic staff to the development of Russian dermatovenerology, to the development of modern methods of diagnosis, treatment and prevention of chronic and infectious dermatoses, as well as sexually transmitted infections.