Clinical relevance. Keratoconus (KC) without clinical manifestations (subclinical stage) occurs in patients with ametropia periodically. Before refractive surgery, in time detection of early signs of this pathology is important as KC is a contraindication to its application.

Purpose: to analyze and compare informative value of the Pentacam HR projection-based tomograph, the TOMEY TMS-4 reflecting-based corneal topographer and the CASIA-2 optical coherent tomograph to identify early signs of KC before refractive laser surgery.

Materials and methods. A prospective study of cornea morphometric parameters in 81 patients (162 eyes) who applied to the Cheboksary branch of the Intersectoral Scientific and Technical Complex “Eye Microsurgery” was performed in order to resolve the issue of refractive surgery possibility with various types of ametropia during the second half of 2020 year. In addition to the generally accepted ones, examinations were carried out using the above-mentioned devices. Age of the patients ranged from 18 to 38 years old (on average 25 ± 5). The sample consisted of 33 (40.81%) men and 48 (59.19%) women.

Results. According to the TOMEY TMS-4 reflecting-based corneal topographer, suspicion of KC was detected in 6 patients (11 eyes) that amounted to 6.79% of all examined patients. The Pentacam HR projection-based tomograph revealed suspicion of KC in 9 patients (18 eyes or 11.11% of all examined patients). While using the CASIA-2 optical coherent tomograph, suspicion of KC was detected by ESI (Ectasia Screening Index) Anterior in 6 patients (11 eyes), and by ESI Posterior in 7 patients (14 eyes) that amounted to 6.79 and 8.64% of all examined patients respectively.

Conclusion. The data obtained during the study showed the greatest informativity and efficiency of the Pentacam tomograph in screening for early signs of KC.

Purpose. To conduct a clinical and functional analysis of contact correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses (RGPSL) in patients after deep anterior lamellar keratoplasty.

Material and methods. Clinical and functional results of correction of postkeratoplastic ametropia with RGPSL were analyzed on the basis of a comprehensive examination of 35 eyes (35 patients) after deep anterior lamellar keratoplasty (DALK) performed for stage III keratoconus. The examination included patients who had low corrected visual acuity with spectacle correction and the corneal suture was removed 1 year or more after deep anterior lamellar keratoplasty. All patients underwent: autorefractokeratometry, visometry, biomicroscopy, computed keratotopography, aberrometry, endothelial cell density calculation, analysis of corneal graft biomechanical properties, optical coherence tomography of the corneal graft. The mean age of the patients was 29 ± 8 years. In all patients, RGPSL was selected on average 1.5 ± 0.85 years after DALK. All RGPSL were from OKVision (OKV-RGP Onefit Med, Canada). The follow-up period was 6 months.

Results. The uncorrected visual acuity was 1.0 ± 1.18 LogMAR, the best corrected visual acuity (BCVA) with glasses was 0.5 ± 0.8 LogMAR, the spherical refractive component was 2.44 ± 2.12 D, the cylindrical refractive component was -6,25 ± 1.24 D. The average value of BCVA in RGPSL increased to 0.72 ± 0.14 (p = 0.0054). The obtained result remained stable during 6 months of observation. In the analysis of corneal aberrations measured with the OPD-Scan II device before and after 6 months after wearing of RGPSL was noted a statistically significant decrease in total corneal aberrations, including higher-order ones. After 6 months of observation, according to Confoscan-4 data was noted the decrease in the density of corneal graft endothelial cells from 2526 ± 332 to 2510 ± 302 cells/mm² (p = 0.0326) and it corresponded to physiological losses.

Conclusions. Clinical and functional analysis of the correction of postkeratoplastic ametropia with rigid gas-permeable scleral lenses during 6 months of follow-up showed high optical efficiency and safety of their use during the entire observation period.

Age-related macular degeneration (AMD) and diabetic angioretinopathy (DARP) are leading cause of vision loss, irreversible blindness and human disability.

Purpose: to find clinical and functional parallels between the assessment of visual acuity in patients with AMD and DARP for determining of treatment method.

Material and methods. The study included the results of examination of patients with DARP and AMD in the period 2018–2021. Group 1 (DARP) consisted of 70 patients (140 eyes): 1A subgroup with non-proliferative form – 45 patients (45 eyes), 1B subgroup with preproliferative one – 36 patients (36 eyes), 1B subgroup with proliferative one – 59 patients (59 eyes). Group 2 (AMD) consisted of 64 patients (109 eyes): 2A subgroup with dry form – 34 patients (67 eyes) and 2B subgroup with wet one – 30 patients (42 eyes); control group – 32 patients (64 eyes). The data of computed perimetry (MD, PSD), optical coherence tomography (OCT) and OCT angiography, visual far acuity test with using the modified ETDRS table with Russian optotypes were analyzed. Fractal analysis of retinal vascular networks (Df1 OCT-angio, Df2 fundus) was performed.

Results. Correlation analysis showed the relationship between Df1 and visual acuity, estimated by the number of ETDRS letters (r = –0.3) for DARP. The acuity of vision in AMD also directly correlates with the MD (r = 0.5) and PSD (r = –0.43) indexes. Df1 differed in 1A and 1Б groups (p = 0.02), as well as 1A and 1B (p = 0.004). Correlation of DARP stages with Df1 (p = –0.6) and Df2 (p = 0.6) was revealed.

Conclusion. The acuity of vision assessed using a modified ETDRS table with Russian optotypes, MD and PSD, Df of vasculature in DARP and MNV in AMD are the criteria in a comprehensive assessment for determining treatment.

Polypoid choroidal vasculopathy (PCV) is a type of wet form of age-related macular degeneration (AMD). It is characterized by formation aneurysmal dilations of abnormal choroidal vessels (polyps) under the retinal pigment epithelium (RPE) in the choroid. The disease leads to a vision loss due to formation of serous retinal detachment, neuroepithelium detachment and RPE, subretinal hemorrhages, fibrosis, atrophy of RPE. The generally accepted treatment of PCV is antiangiogenic therapy.

The purpose of this work is to present and to analyze the clinical case of polypoid choroidal vasculopathy treatment complicated by extensive subretinal hemorrhage.

Description of the case. This clinical case of PCV in the right eye that is complicated by extensive subretinal hemorrhage on the background of antiangiogenic therapy in a 72-year-old man is presented. In addition to standard ophthalmological research methods, we performed optical coherence tomography (OCT) with Cirrus HD-OCT 5000 Zeiss (Carl Zeiss, Germany), angio-OCT with Optovue Solix High-Speed Spectral Optical Coherence Tomograph (Optovue, USA) and fundus photo registration with Topcon TRC-NW8F Retinal Camera (Topcon, Japan). The comprehensive surgical approach was applied to this patient, including posterior subtotal vitrectomy with our Stellaris PC microsurgical system (Baush&Lomb, USA) and the prourokinase subretinal injection against the background of aflibercept antiangiogenic therapy and removal of a concomitant cataract with implantation of an intraocular lens (IOL).

Discussion. The early treatment of this patient and at the right time procedure of microinvasive 25-G vitrectomy combined with prourokinase subretinal injection contributed to the resorption of hemorrhage in the shortest possible time and improved visual functions from 0.02 to 0.6.

Conclusions. The presented comprehensive approach of PCV treatment and its complications made possible to provide social rehabilitation of the patient and to preserve high values of visual functions in the affected eye.

Background. Experimental modeling of various pathological processes in the organ of vision is an integral part of both fundamental and applied research. For a deeper understanding of the pathogenesis of age-related macular degeneration (AMD) and testing of new methods of its treatment, various experimental models of AMD in animals have been developed. However, at the stage of setting up the experiment, each researcher faces the difficult task of choosing an adequate animal model that has the closest homology with human anatomy and pathology, as well as a method for modeling it.

Purpose. To analyze the literature data concerning the choice of AMD experimental model and methods for its modeling, to assess the advantages and limitations of their use in the study of the pathogenesis and effectiveness of modern methods for treating this ophthalmopathology.

Materials and methods. The analysis of publications on PubMed, eLibrary, Cyberleninka resources for the period from 2000 year to the present has been carried out.

Results. The review considers the criteria for selecting experimental models and groups of animals most often used as an object of study (mice, rats, rabbits, pigs and primates). Among the methods for AMD modeling, chemically induced methods (using sodium iodate, N-methyl-N-nitrosourea and cobalt chloride), as well as physically induced methods (mechanical and light damage to reti na) were analyzed.

Conclusion. The use of rabbits as an object of study, even though the macular area is absent, is a well-established model of AMD, in view of the fact that the structure of their reti na corresponds to the general structure of the mammalian retina in areas of greatest visual acuity. Light-induced retinal damage occupies a leading position among AMD modeling methods, which is characterized by a number of advantages – control of the time and intensity of exposure to obtain the required degree of degeneration. The information presented in this review will allow researchers to choose the most adequate model among experimental animals and a method for modeling AMD.

Dry eye disease (DED) is one of the most common conditions encountered by ophthalmologists in their practice. Currently, experts consider meibomian gland dysfunction to be the leading cause of dry eye syndrome. This condition is characterized by obstruction of meibomian gland discharge ducts and/or changes in their glandular secretion, which leads to disturbance of tear film stability and provokes inflammatory process of ocular surface.

The purpose of this publication is to acquaint ophthalmologists and optometrists with the procedure of meibography, a diagnostic method that allows a qualitative and quantitative assessment of the meibomian glands and to determine the degree of their dysfunction.

The first part of the workshop presents the anatomical aspects of the normal structure of the meibomian glands and their dysfunction. The second part describes the technique for diagnosing meibomian gland dysfunction. The third part presents the meibography algorithm and its interpretation.

According to a survey conducted at the Krugozor Ophthalmology Clinics, every second scleral lens wearer regrets that they did not know about the existence of this correction method before. On the one hand, the level of awareness among ophthalmologists and patients of the possibilities and benefits of scleral lenses in the optical rehabilitation of patients with irregular astigmatism increases every year. On the other hand, practitioners often find that patients have to walk for years before they are rerouted to a special contact lenses office for a scleral lens fitting.

In this issue of the journal we share a clinical case of optical rehabilitation of a female patient with keratoconus using scleral lenses, manufactured in Optimum Infinite from Contamac presented by our foreign colleagues Hans Bleshoy & Yett Lassen.