The work of accommodative apparatus has a regulatory effect on the hydrodynamics of eye and it is involved in ensuring the normal outflow of intraocular fluid (IOF). Age-related weakening of accommodation leads to a deterioration in the state of hydrodynamics, and especially significant shifts are expected in patients with axial hyperopia in the anatomical boundaries of “short” eye.

Purpose. To evaluate the effect of correction with progressive lenses and monofocal ones on hydrodynamic indicators and certain morphometric parameters of the anterior chamber in presbyopic patients with hyperopia under conditions of long-term habitual professional eye strain.

Material and methods. 25 subjects (50 eyes) of 44–55 y. o. (mean age 47 ± 1,6 years) were examined in January-July 2022. There were 8 males and 17 females with presbyopia and hyperopia. All patients were examined at the end of their working day: the first examination was performed in the initial state without correction, the second one − under using correction with monofocal lenses (control group) or progressive ones (main group). The examination methods included visometry, autorefractometry, pneumotonometry, ultrasound biometry, computerized tonography, determination of accommodation amplitude using the push-up test, optical coherence tomography of the eye anterior segment.

Results. The critic tension of hydrodynamics, the decreasing of anterior chamber depth and iridocorneal angle width were revealed in presbyopic hyperopic patients under the conditions of eye strain at a near distance without correction with eyeglasses. Using of correction with progressive lenses led to significant increasing of the accommodation amplitude (p < 0,001), decreasing of IOP (p < 0,001), increasing of aqueous humor outflow (p < 0,001), deepening of the anterior chamber (p < 0,001) and increasing of the iridocorneal angle width (p < 0,001) compared to the initial state. No significant changes in these parameters were revealed in the users of monofocal lenses compared to the initial state.

Conclusion. Using of progressive lenses as a permanent correction has a positive effect on ocular hydrodynamics and morphometric parameters of the anterior chamber in presbyopic hyperopes. Lack of correction in hyperopic patients of presbyopic age not only causes of eye fatigue but also can lead to disruption of hydrodynamic balance and development of glaucoma.

Introduction. Acquired myopia (AM) is currently a growing medical and social concern as it is associated with a steadily increasing number of myopic students, early onset of its development, rapid progression and further complications. The main cause of AM is considered to be the depletion of the visual system adaptive capabilities because of too much near vision. According to the adaptation theory, it is necessary to create a high stable level of adaptive reserves of the visual system in order to normalize the process of refractive development in AM. Treatment methods of AM aimed to increase the efficacy and adaptive capabilities of eyes include optical reflex exercises. These exercises in particular using Zenitsa optical simulators compare favorably with other methods due to their physiological and pathogenetic orientation of the action mechanisms.

Purpose. To study the features of using optical simulators “Zenitsa” for the treatment of acquired myopia in school settings and the dynamics of myopic process course.

Material and methods. The group of 25 elementary students (50 eyes, the average age was 9.05 ± 0.72 years) with mild myopia was identified by random sampling. The study was conducted from November to December 2021. 95% of children had asthenopic complaints and 85% of students had a hereditary predisposition to it. The examination included questionnaire, visiometry, skiascopy, ophthalmoscopy, a measure of subjective refraction and relative accommodation reserves, a study of binocular stability of visual perception to hypermetropic retinal defocus. The course of treatment included 10 sessions that were carried out in school settings. We used seven simulators “Zenitsa” each of different optical strength.

Results. After the treatment with the use of optical simulators, visual acuity improved on average from 0.58 to 0.67 (P < 0.01). Subjective refraction decreased from (-)1.48 ± 1.1 to 1.28 ± 1.08 D, by an average of 0.20 D (P < 0.01). Relative accommodation reserves increased from 2.33 ± 0.84 to 3.17 ± 1.07 D, by an average of 0.84 D (P < 0.01). Binocular stability of visual perception increased by an average of 1.5 D that is 15% of the initial level. The value of visual resolution increased by an average of 7.2%.

Conclusion. The use of optical simulator “Zenitsa” sets significantly improves the performance of accommodation and vergence and increases the level of visual system adaptive capabilities in whole.

Background. The study of color vision is of great importance in the diagnosis and monitoring of visual functions in patients with of the partial atrophy of optic nerve (PAON). Due to the fact that PAON is one of the main causes of blindness and low vision in children, there is no doubt about the importance of effective diagnosis of color vision not in children with this pathology.

Purpose: to evaluate the effectiveness of the diagnosis of color vision in children with congenital partial atrophy of the optic nerve using developed own tests in comparison with classical methods. The Rabkin and Neitz-test tables create conditions under which the examined child is given two tasks at once – color discrimination and shape identification. At the same time, the integration of information about color and shape may be difficult in children with PAON.

Materials and methods. In 2020–2022 years 72 school-age children were observed, who, after a standard ophthalmological examination, were divided into two groups: 1) 37 children with congenital bilateral PAON; 2) 35 children of the control group with no pathology of the fundus and normal indicators of visual functions. To study color vision, we used our own developed test images (Patent RU 2760085 of 02.04.2021), as well as classical tests – polychromatic tables E.B. Rabkin and Neitz-test.

Results. In the control group, when studying color vision according to Rabkin tables, four children had some difficulties with determining the shape of test figure in three of the 27 main tables. At the same time, the children named the colors of individual circles that make up the images correctly. In the Neitz-test, only one child did not distinguish between the shapes of brown and green tones of minimal saturation. The other children correctly identified the colored shapes in all the test images. The study with the developed tests did not cause any difficulties for any of the children of the control group. With minimal saturation, all children distinguished chromatic images from achromatic ones and correctly distinguished shades. In the group of children with PAON in the study with classical tests, 15 (40.5%) children experienced significant difficulties with determining the shape of the test figure in some Rabkin tables (while correctly naming the colors of individual circles) and 12 (32.4%) children – in Neitz-test images. Normal trichromasia was detected in 18 (48.6%) children and in 4 (10.8%) children – abnormal trichromasia according to both Rabkin’s tables and Neitz-test. With the developed tests, 6 (16.2%) children had color vision disorders. At the same time, abnormal trichromasia was detected in 4 of them according to the Rabkin and Neitz-test tables.

Conclusion. The test images developed by us are easy to perform and do not pose a difficult visual task for the child to identify the chromatic shape. In this regard, they allow for effective diagnosis of color vision in children in normal and ophthalmopathology, and are also promising for use in children not only of school age, but also of younger age.

Introduction. The existing data in the scientific literature on the role of cytokines as a special biological system, a function of which is the local regulation of regeneration, justifies the relevance of research task in this direction.

Purpose: to study changes of the cytokines concentration in the lacrimal fluid in patients after excimer laser vision correction with LASIK and Femto-LASIK surgery and its correlation with postoperative patients’ parameters.

Methods. The study included 20 patients (40 eyes) with mild myopia and compound myopic astigmatism. The prospective study was carried out in January-August 2022. The patients were divided into 2 groups. In the comparison group (n = 10, 20 eyes) patients underwent LASIK surgery, in the main one (n = 10, 20 eyes) – Femto-LASIK. During the study, the tear fluid was taken and its further biochemical study was carried out to determine the level of cytokines: IL-1β, IL-8, TNF-α.

Results. In the main group, frequency detection of the cytokine IL-1β that is the main pro-inflammatory agent was 80%. In the comparison group it was detected in 90% of the tear fluid samples. Mean IL-1β values were the highest in the comparison LASIK group. Mean TNF-α scores were the highest in the comparison LASIK group. In the same time, differences of the average values between the main and comparison groups were statistically significant (p < 0.05). Mean IL-8 values were the highest in the main group who underwent Femto-LASIK surgery.

Conclusion. The course of regenerative process in patients after excimer laser vision correction depends on concentration of the pro-inflammatory cytokines IL-1β and TNF-α and the anti-inflammatory cytokine IL-8. Based on this, a higher level of the pro-inflammatory cytokines in the lacrimal fluid determines the prolongation of pain relief and epithelialization after surgery.

Introduction. Today the standard of treatment neovascular age-related macular degeneration is frequent intravitreal injections of antibodies to vascular endothelial growth factor. Brolucizumab is one of these medicines, which is a single-chain humanized antibody variable fragment with a very small molecular weight (26 kDa). In our country, there are quite a few publications about the results of using Brolucizumab in the Russian Federation due to the fact that this drug began to be used recently (since mid-2021).

Purpose: to evaluate our own experience with Brolucizumab treatment of neovascular age-related macular degeneration (nAMD).

Materials and methods. The study included 25 patients with nAMD for the period from September 2021 to June 2022, among them 17 women, 8 men, the average age of the patients was 77.07 ± 4.88 years. All patients were divided into 2 groups. The first group included 15 patients previously treated with Ranibizumab. The second group included 10 patients who had not previously received anti-angiogenic therapy. All patients underwent an average of 2 or more IVIs of Brolucizumab and a standard ophthalmological examination, as well as optical coherence tomography (OCT) at the first checkup and one month after each IVI with using the Nidek RS-3000 Advance Angioscan device (Nidek, Japan). All patients included in this study signed an informed consent for it.

Results. Almost all patients during the anti-angiogenic therapy with Brolucizumab showed an improvement in anatomical and functional parameters. In the first group the average visual acuity at the time of data analysis increased by 12.7% compared to the baseline, while in the second group - by 57%. The average thickness of the central retina zone in patients of the first group decreased by 13.8% compared to the initial one, while in the second group by 50.9%. During the study period, one case of an adverse event in the form of moderate vitreitis was registered, which occurred on the 8th day after the fourth IVI of Brolucizumab, previously the patient received two IVIs of Ranibizumab. At the time of data analysis, the patient continued to receive anti-inflammatory therapy with positive dynamics in terms of stopping the symptoms of vitreitis.

Conclusion. This study showed the high efficacy of Brolucizumab in the treatment of nAMD, which was manifested by an improvement in anatomical and functional parameters in patients of both groups. However, the treatment efficacy was higher in patients without previous antiangiogenic therapy. The resulting case of side effect in the form of intraocular inflammation requires a deeper analysis in order to correctly select patients for IVI in the future.

Currently, there is a significant shortage of donor materials for replacing corneal tissue that is why it is relevant to create xenomaterials, which are able to replace a donor cornea with various types of keratoplasty. “Corneoplast” is a new medical device, which is a devitalized, fixed by the method of double crosslinking (dehydrothermic + UV), pork cornea.

Purpose: to assess the biocompatibility and ability to integrate with the recipient cornea of implants based on the xenomaterial “Corneoplast”.

Materials and methods. The experiment was based on biomicroscopy examination, high-resolution optical coherence tomography and histological examination of the experimental rabbits’ corneas (group I–IV: total of 8 eyes were examined), where keratoplasty was performed with the “Corneoplast” material.

Results. High biocompatibility and ability to integrate with the recipient’s cornea were observed in all types of keratoplasty: penetrating, superficial lamellar and intralamellar keratoplasty. On the next day, the implant was transparent with slight swelling of the recipient’s corneal stroma. A week later, the slight swelling of implant was recorded without cornea edema. Its transparency decreased. The recipient’s cornea was reactive. A month later, the moderate neovascularization was noted towards the sutures. After 6 months, the recipient’s cornea was clear, transparent. The implant was translucent and neovascularization was absent. The entire surface of cornea and implant was epithelialized. On the series of optical coherent tomograms, a normal thickness of the epithelium continuous layer was determined in 6 months after the surgery. The complete integration of material with the recipient’s cornea was noted. The layered structure characteristic of corneal tissue was preserved. The cornea retained a layered structure and the endothelium was preserved. On histological examination, there were no differences in the intact cornea and implanted material.

Conclusion. The “Corneoplast” material is sufficiently biocompatible and capable of integration with the recipient’s cornea in an animal experiment. This allows, at a certain stage of preclinical trials completion, to use it for replacing corneal tissue in penetrating keratoplasty, intralamellar and superficial anterior layer-by-layer implantations and to cover purulent corneal ulcers of various depths.

Background. Determination of reflex accommodation indicators is of particular interest, both from clinical and scientific points of view. However, the heterogeneity of methods and approaches for evaluation of results obtained makes it necessary to compare and confront them in details.

Purpose: to summarize and systematize the literature-based data of modern accommodation measurement methods.

Methods. The analysis of domestic monographs was carried out. The domestic and foreign articles on eLibrary and PubMed within the last 20 years were analyzed. The articles with an incomplete selection criteria and statistically unreliable results (p < 0.05) were excluded.

Results. Though the measurements of reflex accommodation indicators by subjective methods are consistent with each other, they are overestimated compared to the results of objective studies. Among the objective methods, special attention should be paid to the open-field autorefractometers as they level possible instrumental accommodation that is typical for the closed-field autorefractometers. Regarding this, it is necessary to clarify the methods used in the studies of this direction. By taking into account the indicators of reflex accommodation for assessing pathological conditions and treatment results, it is necessary to consider relative (i. e., comparative) measurement values but not absolute ones.

Conclusion. The analysis of literature sources showed that the modern approaches of reflex accommodation study were very different. The methods discussed in this review are suitable for both clinical and scientific practice application. However, a mandatory reference to the method used is required for a correct assessment of results.

Contact lens options for astigmatic patients include commercially available toric soft contact lenses, custom soft contact lenses, rigid corneal and scleral contact lenses. Wide range of parameters and modalities of modern soft toric lenses covers more than 90 % of patients with astigmatism. It makes toric soft contact lenses most available and convenient option for eyecare specialists.

Purpose of this publication is to review main steps of toric lens fitting and remind ECP about useful tools and services designed to reduce chair time.