22 августа 2023 года исполняется 70 лет известному ученому, офтальмологу, заместителю председателя Ассоциации офтальмологов Узбекистана, профессору кафедры офтальмологии Ташкентской медицинской академии, доктору медицинских наук, профессору Фазилат Арифовне Бахритдиновой.

Introduction. Understanding the peculiarities of perception of color images by patients with achromatopsia helps to identify and differentiate this pathology from diseases with similar clinical symptoms in time. This is becoming increasingly relevant due to ongoing developments in the field of virus vector therapy using an adeno-associated virus carrying the CNGB3 and CNGA3 genes.

Purpose: to investigate the features of perception of color images by patients with achromatopsia, using in addition to the generally accepted developed proprietary tests to quantify the brightness of perceived images.

Materials and methods. Five school-age patients (12–17 years) with complete achromatopsia were observed. The control group included 36 schoolchildren aged from 10 to 17 (av. 13.4 ± 0.5) with a normal state of visual functions. The ophthalmological examination included standard research methods. In children with achromatopsia, OСT data and ERG indicators were taken into account. To study color vision in all children, the following methods were used: E.B. Rabkin’s polychromatic tables, Neitz Test, Farnsworth–Munsell Dichotomodus D-15 Test, a study of the field of vision for white and colored stimuli (on the perimeter of PNR-03). In addition, in children with achromatopsia, the perception of color stimuli with achromatic stimuli was compared using special proprietary images.

Results. Comparison of the results of the study of color vision in patients with achromatopsia in different ways demonstrates the greatest probability of diagnostic errors when using polychromatic tables, which may be due to the ability of these patients to distinguish test figures in some tables based on brightness contrast, rather than contrast of color tones. Increased sensitivity of photoreceptors to short-wave (blue part of the spectrum) radiation and significantly reduced sensitivity to short-wave (red part of the spectrum) in patients with achromatopsia may cause the expansion of the boundaries of the field of view to green and blue stimuli (while the boundaries of the field of view to the blue stimulus almost reach the values for the white stimulus), as well as a significant narrowing to red stimuli compared with the indicators in the control group (p < 0.001). The developed own test images made it possible to quantify the brightness of chromatic stimuli perceived by patients with achromatopsia in comparison with the brightness of achromatic stimuli. The brightest (90–100%) for them was the blue stimulus and practically merged with the white background of the screen. The red stimulus was perceived to be the darkest (minimum brightness). Based on the data obtained, an approximate model of the perception of color images in achromatopsia was created. Conclusion. The obtained data complement the existing ideas about the peculiarities of perception of color images by patients with achromatopsia and can be used to develop new and improve existing methods of diagnosing this disease, as well as to create recommendations for the design of illustrative, educational and advertising material.

Introduction. Blepharorrhaphy (BR) is an operation aimed at reducing the size or complete closure of the eye slit, a technically simple and proven technique used in the treatment of patients with various diseases of the eye accessory apparatus, eyeball and orbit. But to date, there are no clear criteria for choosing the type of operation (temporary or permanent, the latter is full or partial) and evaluating its effectiveness.

The purpose of the study: to evaluate the effectiveness of the use of blepharorrhaphy various types in the complex treatment of the eye anterior part diseases.

Material and methods. The analysis of case histories and outpatient records of patients who underwent blepharorrhaphy surgery in the ophthalmological department of the City Clinical Hospital No. 2 named after Dr. F.Kh. Gral’ in Perm in 2020–2021 was carried out.

Results. 42 partial blepharorrhaphy surgeries were performed, including temporary suture and non-bloody permanent ones in 30 patients in 35 eyes. The type of BR and the period for which the stitches were applied were determined individually depending on the severity of the lesion. At the same time, the cornea was coated with the “Alloplant” material for the conjunctiva and cornea. All patients were divided into 4 groups depending on the etiology of the pathological process. According to the indications the BR was repeated. The analysis of treatment results was carried out within each group in the early postoperative and long-term periods.

Conclusions. The effectiveness of blepharorrhaphy was assessed by the possibility of preserving the eye as an organ, it was possible in 94%. The preserved eyes needed further rehabilitation. The choice of one or another type of operation should depend on a number of conditions and the approach in each case should be strictly individual.

Introduction. The modern realities of the Russian market of contact lens care products dictate the search for a universal solution for one-stage cleaning, which has high disinfecting and cleansing properties for all types of contact lens materials.

Purpose: investigation of the disinfecting properties of the multifunctional solution “OKVision GOLD” in relation to scleral gas-permeable lenses.

Materials and methods. 20 patients (40 eyes) with keratoconus of various stages (average age 32.6 ± 2.3 years) were examined before and after wearing scleral lenses in the daytime. A clinical ophthalmological study was conducted, including a biomicroscopic assessment of the lens surfaces, as well as the anterior segment of the eye with the use of vital dyes before and after lens cleaning. In addition, smears were collected for further bacteriological examination. Evaluated: a) initial smear from the conjunctiva of the patient before putting on the contact lens; b) a smear from two surfaces of the lens after wearing it for 12 hours; c) a smear from two surfaces of the lens after 6 hours of treatment in solution. The place of analysis: G.N. Gabrichevsky research institute for epidemiology and microbiology.

Results. Sowing smears from the conjunctiva before using contact correction revealed the presence of opportunistic flora. Sowing after 12 hours of wearing lenses determined the attachment of pathogenic flora. Examination of smears from lens surfaces after their 6-hour exposure in solution revealed complete inactivation of previously detected pathogenic and insignificant presence of conditionally pathogenic flora. During biomicroscopy, the condition of the eye surface remained unchanged, no deposits on the lenses were recorded. The survey of patients also revealed no negative reactions.

Conclusion. The results of clinical and bacteriological studies indicate high disinfecting activity against conditionally pathogenic and conditionally pathogenic flora in the treatment of scleral lenses. This solution can be recommended for the care of all types of contact lenses, including gas-permeable ones.

Collagen crosslinking – the formation of cross-links between polypeptide chains – reduces the latter’s ability to hydrate. This property is universal for any variant of crosslinking (chemical, physical, physico-chemical) and for any form of collagen (gelatin, fibrillar collagen). Dehydrothermal crosslinking (DTC) is the formation of cross-links in biomaterials when they are heated under vacuum. Despite the fact that DTC methods are widespread in tissue engineering, its effect on the properties of the corneal stroma has not been practically studied. The use of DTK at temperatures up to 200 °C is described. For corneal stroma, the temperature limits of DTC treatment that allow its transplantation are unknown.

Purpose: to evaluate the effect of dehydrothermal (DHT) cross-linking of stromal corneal grafts based on the “Corneoplast” material at temperatures of 60, 100, 140, 180 and 220 °C on their principal applicability in keratoplasty.

Materials and methods. A corneoscleral disc was excised from a porcine eye (<12 h post-mortem) with epithelium and Descemet’s membrane removed, dried, and a 10 mm central corneal graft was cut out. Dry grafts (n = 36) were divided into 6 groups of 6 samples: in five groups they were kept under vacuum for 3 days at 60, 100, 140, 180, 220 °C; group 6 – untreated control; the structure was evaluated according to small-angle X-ray scattering and atomic force microscopy; for other studies, the grafts were immersed in a phosphate-salt buffer for 24 hours. Parameters evaluated: gross appearance, image quality from 5 m, light transmission, water content, central thickness, suture retention load. A test for epithelialization was performed ex vivo after 3 days in fresh porcine cornea organ culture.

Results. The 220 °C mode caused charring destruction of the material. The grafts after 180 °C became significantly weaker than the 9-0 nylon thread. In the range of 60–140 °C suture retention load significantly lowered from 913 (control) down to 137 g (140 °C). Grafts increased their light transmission from 30 (control) up to 75% (140 °C); the central thickness went from 3000 (control) down to 320 um (140 °C), water content decreased from 94 (control) down to 44% (140 °C). Subjective image quality of the grafts after treatment at 60, 100, and 140 °C increased and grafts allowed distinguishing optotypes 0.3, 1.0, and 1.0 decimal, respectively. In organ culture control grafts and grafts after 60 and 100 °C treatment were covered with epithelial cells. 140 °C samples showed smooth surface with no cells upon.

Conclusion. The limits of DTC processing are determined. Changing the temperature regime of DTK makes it possible to control the basic properties of “Corneoplast” in a wide range to achieve the possibility of using it as a keratoplastic material.

Conjunctivitis, according to various studies, is the most common reason for going to the initial outpatient appointment and can be caused by several factors at the same time. Treatment is carried out comprehensively, depending on the clinical picture, somatic status and anamnesis data. In accordance with the clinical guidelines developed by the Russian Association of Ophthalmologists, the following groups of drugs are recommended for use: antibacterial, antiseptic, antihistamine, nonsteroidal anti-inflammatory drugs.

Purpose: to analyze the use of the above groups of drugs in the treatment of conjunctivitis in order to recommend a reasonable prescription of the necessary therapy.

Materials and methods. The literature data on the study of the features of the action of the above pharmacological groups in the treatment of conjunctivitis, obtained on the resources of PubMed, eLibrary, Crossref Metadata, mainly over the past 20 years, are presented.

Results. The presence of signs of an allergic reaction involves the appointment of antiallergic drugs with multiple pharmacological effects – blockade of histamine receptors, stabilization of mast cell membranes and suppression of eosinophil filtration. Given the different mechanisms of action within this group of drugs, it is necessary to select them individually. When prescribing tablet forms of antihistamines, it must be remembered that with prolonged use, they can cause patients to feel dry in their eyes. In cases where the above antiallergic drugs do not adequately control the allergic inflammatory process, anti-inflammatory drugs are used. Nonsteroidal and steroid anti-inflammatory drugs are used as anti-inflammatory drugs. Usually nonsteroidal anti-inflammatory drugs are recommended for use in chronic conjunctivitis and patients with a history of systemic diseases. Steroid drugs are indicated for severe forms of manifestation of the allergic process on the eyes, as well as the appointment of steroid anti-inflammatory drugs is recommended for use in short courses (up to 2 weeks), and with their longer use, control of intraocular pressure is necessary. Literature data indicate the lack of efficacy of antiviral drugs such as acyclovir and others from this group in the treatment of conjunctivitis of adenoviral etiology. Drugs with an immunomodulatory effect based on interferon or inducers of interferon synthesis are widely used. The prescription of antibiotics should be justified, since in recent years the level of resistance to them has significantly increased. Antiseptics that have a wide spectrum of action (bacteria, viruses, fungi and protozoa) are an alternative to antibiotics, but it must be remembered that this group of drugs often causes allergic reactions.

Conclusion. The treatment of conjunctivitis must be approached carefully, taking into account not only the etiology of the disease, but also the somatic and immune status of the patient. To avoid the negative effects of the use of antibiotics, replace them with alternative drugs and do not use them in the treatment of conjunctivitis of a non-bacterial nature.

Approximately 60% of individuals who use contact lenses prefer to use frequent replacement lenses. Despite various improvements in contact lens technology, there has been minimal progress in weekly/monthly lenses. Meeting the requirements of patients who prefer frequent replacement lenses demands new technological advancements. Experts analyse the concept of biomimicry and its role in enhancing the relationship between contact lenses and the ocular surface.

Diabetic retinopathy is a microangiopathy that occurs as a result of chronic prolonged exposure to high glucose levels on the retina of the eyes. In optometric practice, a specialist, on the one hand, faces the impossibility of performing a complete correction of vision, and on the other, may be the first to suspect such a pathology and refer the patient to a doctor. At the same time, it should be noted that medical professionals specializing in the treatment of diabetes often work in isolation, which requires patients to visit several clinics and specialists. Despite the great relevance, in many countries, difficulties remain in coordinating treatment programs for narrow-profile specialists who provide assistance to people living with diabetes. In this article we discuss the epidemiology, describe an approach to its assessment, diagnosis and provide an overview of the principles of treatment of diabetic retinopathy. In this article we discuss the epidemiology and natural history of diabetic retinopathy and describe an approach to its assessment, diagnosis and provide an overview of the principles of treatment of diabetic retinopathy. The article mentions a large number of people with diabetic retinopathy in the world, including in Russia, and notes that the actual prevalence is probably higher than the reported figures.

Более 15 лет Академия оптометрии (АНО «Академия медицинской оптики и оптометрии») ведет образовательную деятельность (лицензия № 041041 от 16 октября 2020 года, выдана Департаментом образования и науки г. Москвы) в сфере дополнительного профессионального образования, повышения квалификации специалистов, совершенствования их профессиональных знаний, умений и навыков в области медицинской оптики, офтальмологии, сестринского дела, организации здравоохранения и общественного здоровья. За это время обучено более 10 000 специалистов, многие из которых проходили обучение неоднократно.

Основным конкурентным преимуществом Академии является научно-педагогический коллектив, объединяющий талантливых офтальмологов – ученых и преподавателей, имеющих степени кандидата и доктора наук. Самое современное диагностическое оборудование позволяет дать слушателям реальные представления о диагностике рефракционных нарушений и возможных способах их коррекции.