Ophthalmology

Анисимов, С. И. Особенности интраокулярной коррекции афакии после проведенных кераторефракционных операций: литературный обзор. Часть 1 / С. И. Анисимов, М. А. Косаковская, Н. С. Анисимова // The EYE ГЛАЗ. – 2024. – Т. 26, № 3. – C. 180–188.

(Intraocular aphakia correction in patients with prior keratorefractive surgery: literature review. Part 1)

 Introduction. An increasing number of patients with a history of keratorefractive surgeries are presenting to ophthalmologists with complaints of vision loss due to cataracts. Treating this group poses surgeons with a range of unique challenges: high demands for vision quality, complexities in selecting the appropriate intraocular lens (IOL) power calculation formula and IOL model, target refraction, as well as the need to modify cataract extraction techniques and address specific postoperative considerations. Despite advancements in the development of new IOL designs and calculation formulas, clinical and functional outcomes in this group remain inferior to those in patients without prior keratorefractive procedures. A paradigm shift is emerging, advocating for a personalized approach in the diagnosis and management of cataracts in these patients. However, discussing all aspects within a single review proved impractical, leading us to divide it into two parts. The objective of the first part of this study is to assess the specific considerations for aphakia correction in patients who have undergone keratorefractive procedures, based on literature data, while taking into account the long-term complications of refractive surgery. Additionally, this part will address the fundamental principles of the design and functionality of pseudoaccommodating intraocular lenses (IOLs). Materials and methods. A selection of over 200 peer-reviewed publications from resources such as PubMed, eLibrary, CyberLeninka, Science Direct, and Google Scholar over the past 30 years was conducted. The first part of the review includes 49 publications. This work represents an analysis of contemporary literature, reflecting the impact of keratorefractive surgeries on the successful performance of phacoemulsification with IOL implantation. Results. The findings from the first part of the analysis indicate that a detailed medical history of previously performed keratorefractive corrections – specifically their type and potential long-term complications – play a significant role in determining the surgical treatment strategy. Standard examination methods do not always fully reflect the optical characteristics of the cornea in these patients. Extended preoperative assessments, including specialized techniques such as keratotopography and keratotomography, are crucial for identifying corneal irregularities and for the subsequent selection of the type of intraocular lens (IOL) for aphakia correction in patients who have undergone keratorefractive surgeries. Studies show high effectiveness not only in using monofocal lenses but also in the potential application of pseudoaccommodating IOLs, including those with extended depth of focus and multifocal lenses. The selection of optimal formulas for IOL calculation, as well as the clinical aspects influencing refraction in the postoperative period, will be addressed in the second part of the literature review. Conclusion. The increase in the number of refractive surgeries has led to a growing population of patients with cataracts following ametropia correction. This has spurred the development of new IOL variants with extended depth of focus. However, literature data on their effectiveness in patients who have undergone keratorefractive procedures remain limited. Multicenter prospective studies are needed to evaluate new IOL models and to determine the optimal surgical strategies for this category of patients.
Борисов, Ф. Г. Синдром дисфункции хрусталика (обзор литературы) / Ф. Г. Борисов, И. А. Лоскутов // The EYE ГЛАЗ. – 2024. – Т. 26, № 3. – C. 189–194.

(Dysfunctional lens syndrome: a literature review)

 Introduction. The term “Dysfunctional Lens Syndrome” (DLS) refers to age-related changes in the lens, including early cataracts and presbyopia, that do not significantly reduce visual acuity. This syndrome is characterized by a decrease in accommodative amplitude, an increase in light scattering, and a reduction in contrast sensitivity. With rising life expectancy, the prevalence of DLS is increasing, necessitating a more in-depth study of the pathogenic mechanisms underlying the syndrome and the refinement of its diagnostic criteria to establish standards for treatment correction. Aim: to summarize information on the pathogenesis of DLS, the potential for staging the syndrome using objective examination methods, and to provide treatment recommendations. Materials and methods. A bibliographic study of scientific publications was conducted using the Pubmed, ScienceDirect, and Cyberleninka databases. Literature sources were searched using the following keywords: dysfunctional lens syndrome (DLS), presbyopia correction, cataract, age-related lens changes. A total of 32 publications, primarily from the last 10 years, were included in the study from more than 100 viewed sources. Results. The DLS encompasses a wide range of conditions, from early stages characterized by a loss of accommodative amplitude and minor refractive anomalies to later stages involving a decrease in visual acuity and quality due to increased light scattering and aberrations. Currently, the evaluation of age-related lens changes involves assessing visual acuity and determining the degree of lens opacification using slit-lamp examination. Additionally, objective instrumental methods, such as optical coherence tomography and Scheimpflug imaging, can be used to assess the degree of lens opacification. Various methods are employed for the correction and treatment of DLS, ranging from glasses and contact lenses to surgical interventions, such as lens extraction and intraocular lens implantation. Research is also ongoing into drugs aimed at slowing the progression of lens changes. Conclusion. The term “Dysfunctional Lens Syndrome” is currently used to describe early cataracts and presbyopia, where the reduction in visual acuity is still minor, but patients experience visual complaints due to age-related lens changes. Further research is necessary to develop and standardize diagnostic criteria and to evaluate the effectiveness of new treatment methods and interventions in order to create the most effective and adequate approach to correcting DLS and alleviating the associated visual complaints.
Семенова, Н. С. Вителлиформные субретинальные депозиты: общность патогенеза и многообразие клинической картины / Н. С. Семенова, Е. К. Педанова // The EYE ГЛАЗ. – 2024. – Т. 26, № 2. – C. 116–125.

(Vitelliform subretinal deposits: shared pathogenesis and clinical diversity)

 Since its initial description, Best vitelliform macular dystrophy has been strongly linked to characteristic retinal lesions—subretinal yellowish accumulations, with a hyperreflective structure on optical coherence tomography, situated above the retinal pigment epithelium layer. However, research on this topic remains scarce. It is now recognized that, within the common pathophysiological mechanism of vitelliform lesion formation, this process may contribute to the pathogenesis of a broad spectrum of both genetic and acquired conditions. The purpose of this review is to update our understanding of genetically determined and acquired retinal diseases associated with the formation of such lesions. Materials and methods. analysis of scientific publications from databases including PubMed, ScienceDirect, and Cyberleninka was conducted. The review encompasses 16 studies, predominantly from the past decade. Results. Advances in instrumental and genetic diagnostics have revealed that vitelliform subretinal changes are not exclusive to Best disease but serve as another biomarker, indicating disruption in the metabolism of outer retinal layers. It is hypothesized that, irrespective of etiology, the primary triggering factor for lesion formation is the disjunction of outer segments of photoreceptors and impairment of phagocytic function in retinal pigment epithelial cells. This article presents a contemporary perspective on the presumed etiology and pathophysiology of vitelliform lesions, alongside clinical characteristics, manifestations, and prognosis of diseases associated with this phenomenon. Diseases with identified genetic mutations in the BEST1 gene (Bestrophinopathies) and PRPH2, as well as common acquired conditions like age-related macular degeneration and vitreoretinal traction syndrome, are discussed. Conclusion. The provided clinical characteristics, supported by multimodal visualization, are expected to aid in differential diagnosis and prognostication of the disease course.
Применение машинного обучения при диагностике глаукомы: систематический обзор / А. А. Байболдина [и др.] // Офтальмология. Восточная Европа. – 2024. – Т. 14, № 3. – С. 395–410.

(Application of Machine Learning in Glaucoma Diagnosis: A Systematic Review)

 Introduction. Glaucoma is a progressive disease of the visual organ and is one of the most common causes of incurable blindness worldwide. Therefore, early diagnosis of this disease is crucial in modern ophthalmology. However, this process can be labourintensive and expensive, therefore there is a constant need to develop more effective complex diagnostic methods. It is relevant to introduce machine learning technologies in medical decision making and improve the quality of disease diagnosis.
Purpose. To conduct a systematic selection of published scientifi c papers devoted to the problem of applying machine learning in the diagnosis of glaucoma, to analyse the accuracy and effi ciency of the investigated technologies. Materials and methods. We analysed articles published in 2014–2024 on the application of machine learning in glaucoma diagnosis. The literature search was performed in PubMed/MEDLINE and eLibrary databases using the keyword groups “machine learning”, “glaucoma”, “diagnostic”. After reviewing the full text of 48 papers that met the selection criteria, 24 articles that were most relevant to the task were selected. Results. The sources describing the application of artifi cial intelligence technologies, in particular machine learning, for glaucoma diagnosis are analysed. The existing methods of differentiating normal from pathological parameters are considered, information about the used data sets for building mathematical models is presented, the quality and efficiency of the models are evaluated, and the main advantages and disadvantages of the used classifi cation methods are highlighted. Models based on machine learning algorithms have demonstrated prediction accuracy above 90%, confi rming the potential of applying these methods to glaucoma diagnosis. Conclusion. There is a signifi cant interest of the world scientifi c community in the application of artifi cial intelligence technologies, in particular, machine learning methods, in the diagnosis and prognosis of glaucoma. The introduction of machine learning methods in ophthalmology seems to be a promising tool for increasing the detection of the disease at early stages.
Бабаева, Д. Б. Биомеханика диабетического витреопапиллярного тракционного синдрома / Д. Б. Бабаева, М. М. Шишкин, Р. Р. Файзрахманов // Вестник офтальмологии. – 2024. – Т. 140, № 2. – С. 78–82.

(Biomechanics of diabetic vitreopapillary traction syndrome)

 Diabetic vitreopapillary traction syndrome (VPT) is a variant of diabetic retinopathy (DR) that can lead to vision loss in advanced stages. This review reports on the biomechanics of the vitreous in the pathogenesis of proliferative DR, in particular diabetic VPT. The article analyzes and summarizes literature data, presents the views of different authors on this problem, and provides the results of Russian and foreign scientific research on this pathology. It is concluded that further research in this area can lead to a significant improvement in the results of therapy, timely diagnosis, and preservation of vision in patients with DR.
Альтернативные методы хирургического лечения кератоконуса / А. В. Терещенко [и др.] // Вестник офтальмологии. – 2024. – Т. 140, № 2. – С. 85–90.

(Alternative methods of surgical treatment of keratoconus)

 The introduction of early diagnostic methods for keratoconus into clinical practice has become the basis for the development of surgical treatment techniques for this pathology, such as corneal collagen crosslinking and interlamellar keratoplasty with implantation of intrastromal segments. The article analyzes the results of research by Russian and foreign specialists in these areas and presents the data on the combination of SMILE surgery and corneal crosslinking, the Rome protocol of corneal crosslinking, modifications of interlamellar keratoplasty, the use of femtosecond laser technologies, and some pilot studies. Modern requirements for ophthalmological care require a personalized approach to each patient, and therefore the surgeon should have a wide range of surgical methods of treatment applicable to different patient cohorts. The described methods of treatment, according to the authors, are the most promising.
Самойлов, А. Н. Патогенетические основы развития атрофии зрительного нерва при токсическом поражении метанолом / А. Н. Самойлов, А. М. Бариева, А. А. Кузнецова // Вестник офтальмологии. – 2024. – Т. 140, № 2. – С. 91–96.

(Pathogenetic basis of optic nerve atrophy in methanol poisoning)

 Optic nerve atrophy is a pathomorphological consequence of diseases of the peripheral neuron of the visual pathway, manifested as atrophy of nerve fibers of varying severity. The toxic effect of methanol is mainly associated with formic acid and formaldehyde, which suppress the cytochrome system, inhibit oxidative phosphorylation, and thereby cause a deficiency of adenosine triphosphoric acid, to which brain and retinal tissues are especially susceptible. When formiate accumulates, tissue respiration is disrupted, leading to pronounced tissue hypoxia. As a result of such methanol metabolism, metabolic acidosis occurs. Tissue hypoxia develops in the first few hours as a result of the action of formic acid on the respiratory enzyme chain at the cytochrome oxidase level. Hypoxia and, as a consequence, a decrease in energy supply lead to a disruption of biological oxidation and the development of apoptosis in the optic nerve fibers. Understanding the process of optic nerve atrophy development at the pathogenetic level in methyl alcohol intoxication will help make a correct early diagnosis and prescribe timely treatment.
Захарова, О. А. Водоградиентные контактные линзы: научные и клинические данные, лежащие в основе инновационных технологий контактной коррекции / О. А. Захарова, С. Е. Напалкова // Офтальмология. Восточная Европа. – 2024. – Т. 14, № 2. – С. 283–291.

(Water Gradient Contact Lenses: Scientific and Clinical Evidence Behind Breakthrough Contact Lens
Technology)

 In recent decades, Alcon’s research and development has been focused on achieving the most gentle interaction between contact lenses and the ocular surface. The result is the development of materials that replicate the structure and properties of ocular surface structures. To accomplish this, Alcon is stepping away from traditional hydrogel and silicone hydrogel technologies by combining materials with diff erent characteristics in one contact lens: a silicone hydrogel core and a highly hydrophilic hydrogel surface. This approach is the basis for the development of a new category of materials – water-gradient contact lenses. This review examines the scientific and clinical evidence behind these revolutionary innovations.
Маркеры нейровоспаления у пациентов с первичной открытоугольной глаукомой (обзор литературы) / В. Е. Корелина [и др.] // Офтальмология. Восточная Европа. – 2024. – Т. 14, № 2. – С. 292–301.

(Markers of Neuroinflammation in Patients with Primary Open-Angle Glaucoma: Review)

 The article discusses the possibilities of diagnosing glaucoma using glial biomarkers. Neuroglial cells play a key role in the development of neuroinfl ammation in glaucoma. Determining the activity of retinal glial cells will help identify specifi c biomarkers of the incipient glaucomatous process. Among the biochemical markers of neuroinfl ammation, neurospecifi c proteins are being actively studied. The authors analyze the available data on some of them. Protein S100 is the most studied glial biomarker and is already used in laboratory diagnostics. In glaucoma, signifi cant changes in S100β are observed. It signifi cantly increases at beginning of disease. With a long-term glaucomatous process, the number of astrocytes decreases and S100 β decreases. Neuron-specifi c enolase during ischemia of nervous tissue makes it possible to judge the severity of neuronal damage. Myelin basic protein, a marker of damage to glial cells involved in axonal myelination, indicates the degree of demyelination of fi bers. Proven changes in the myelin of optic nerve fi bers in experimental glaucoma suggest the possibility of using this biomarker in the preclinical diagnosis of the glaucomatous process. In primary open-angle glaucoma, a signifi cant decrease in the level of brain-derived neurotrophic factor is also detected. Ciliary neurotrophic factor belongs to family of cytokines, expressed by glial cells. In experimental glaucoma, increased synthesis of ciliary neurotrophic factor in Müller cells is recorded. Tumor necrosis factor produced by astrocytes, microglia and promotes the death of retinal ganglion cells. In glaucoma, an imbalance of tumor necrosis factor andits receptors is determined, which allows to propose this factor as potential biomarker of the glaucomatous process. High activity of microglial cells in glaucoma is accompanied by the expression of interleukins (IL): IL-1, IL-6, IL-12, IL-10. The sensor protein NLRP3 is involved in the immunopathogenesis of neuroinfl ammation and the enhancement of neurodegenerative processes in primary open-angle glaucoma. Modern laboratory technologies can allow us to reach new molecular level for diagnosing glaucoma.
Гиясова, А. О. Применение субпорогового микроимпульсного лазерного воздействия для лечения диабетического макулярного отека. Обзор литературы / А. О. Гиясова, Н. Р. Янгиева // Лазерная медицина. – 2023. – Т. 27, № 2. – С. 42–47.

(Subthreshold micropulse laser light in diabetic macular edema (literature review))

 The authors present a review on analyzing techniques for the treatment of diabetic macular edema. Subthreshold micro-pulse laser light is an effective and safe technique for managing diabetic macular edema which can be prescribed repeatedly. The effectiveness of subthreshold micro-pulse laser light is increased in combination with pharmacological therapy which includes inhibitors of the vascular endothelial growth (VEGF) factor.
Хирургическое лечение глаукомы c применением дренажей у пациентов с артифакией / М. А. Фролов [и др.] // Национальный журнал Глаукома. – 2023. – Т. 22, № 3. – С. 70–78.

(Risks in the surgical treatment of far-advanced glaucoma in the only seeing eye)

 This review summarizes the results of surgical treatment of faradvanced stage glaucoma in the only seeing eye. A literature search performed in the PubMed search engine and aimed at finding publications reporting the clinical outcomes of treatment in patients with glaucoma in the only seeing eye did yield sufficient data related to the topic. A comprehensive analysis of the available data was performed with an emphasis on the choice of treatment tactics and postoperative results at various times following a surgery. Several studies allowed to perform a comparison of the clinical advantages and costeffectiveness of medical treatment versus surgery for advanced glaucoma, as well as to assess potential risks and adverse outcomes such as glaucoma progression, postoperative scarring, hypotension and other complications. The results presented in this review suggest that common success criteria can provide uniformity in academic studies, but in daily clinical practice each glaucoma specialist must make a patientspecific decision in favor of either of these methods of treatment in order to guarantee an optimal result, both for the doctor and, of course, for the patient.
Риски хирургического лечения глаукомы на единственном видящем глазу с далекозашедшей стадией заболевания / А. Б. Захидов [и др.] // Национальный журнал Глаукома. – 2023. – Т. 22, № 3. – С. 79–86.

(Risks in the surgical treatment of far-advanced glaucoma in the only seeing eye)

 This review summarizes the results of surgical treatment of far-advanced stage glaucoma in the only seeing eye. A literature search performed in the PubMed search engine and aimed at finding publications reporting the clinical outcomes of treatment in patients with glaucoma in the only seeing eye did yield sufficient data related to the topic. A comprehensive analysis of the available data was performed with an emphasis on the choice of treatment tactics and postoperative results at various times following a surgery. Several studies allowed to perform a comparison of the clinical advantages and cost-effectiveness of medical treatment versus surgery for advanced glaucoma, as well as to assess potential risks and adverse outcomes such as glaucoma progression, postoperative scarring, hypotension and other complications. The results presented in this review suggest that common success criteria can provide uniformity in academic studies, but in daily clinical practice each glaucoma specialist must make a patient-specific decision in favor of either of these methods of treatment in order to guarantee an optimal result, both for the doctor and, of course, for the patient.
Симакова, И. Л. О целесообразности и возможности скрининга глаукомы в современных реалиях / И. Л. Симакова, Л. А. Григорян, С. А. Сердюкова // Национальный журнал Глаукома. – 2023. – Т. 22, № 3. – С. 87–97.

(The possibility and practicality of glaucoma screening in modern society)

 Glaucoma is one of the main causes of low vision and irreversible blindness both in Russia and all over the world. Taking into account the huge budget expenditures of any country, both direct and indirect, required to provide ophthalmological care to a sufficiently large contingent of glaucoma patients, including annual losses of economic productivity associated with visual impairment, the practical importance of glaucoma screening is beyond doubt. In addition, identification of patients at the onset of the disease would allow earlier start of the treatment aimed at stabilizing the glaucoma process. However, the questions remain whether it is possible to perform glaucoma screening in current realities, as well as what research methods should be used. To find the answers to these questions, we reviewed the literature and analyzed modern publications on the problem of glaucoma screening in different countries.
Особенности нарушения толерантности к гипотензивному лечению у пациентов с первичной открытоугольной глаукомой и наследственно отягощенным анамнезом заболевания / И. А. Булах [и др.] // Национальный журнал Глаукома. – 2023. – Т. 22, № 3. – С. 98–108.

(Specific features of impaired tolerance to antihypertensive treatment in patients with primary open-angle glaucoma and a hereditary history of the disease)

 This review considers possible reasons for the decrease in the effectiveness of antihypertensive treatment in primary open-angle glaucoma (POAG) patients with a family history of the disease, presents clinical practice examples of the effectiveness and duration of antiglaucoma topical therapy and the mechanisms and manifestations of tachyphylaxis and tolerance disorders in such patients. Clinical features and the nature of POAG progression in patients with a hereditary predisposition may be reflected in the early decrease in the effectiveness of antihypertensive treatment. In some recent publications the authors proved a more aggressive course of POAG in patients with a family history of the disease, but despite that, such works at the moment are very limited in number and unsystematized. This, in turn, prevents drawing unambiguous conclusions regarding the features of the prescribed antihypertensive therapy. The article also discusses modern aspects of pharmacogenetics in patients with POAG, its further development will help minimize unwanted side effects as well as increase the effectiveness of antihypertensive drug treatment. The results of the work presented in this review allow systematization of the available data on impaired tolerance to antihypertensive therapy and maintain the need of further clinical research in this area.
Иванов, Д. И. Сравнение патогенетически ориентированных методов, направленных на активацию трабекулярного аппарата при хирургическом лечении катаракты / Д. И. Иванов, М. Е. Никулин // Национальный журнал Глаукома. – 2023. – Т. 22, № 3. – С. 109–120.

(Comparison of pathogenetically oriented methods aimed at activating the trabecular meshwork in the surgical treatment of cataract)

 In modern ophthalmic surgery, the “gold standard” recognized by most surgeons is ultrasound cataract phacoemusification, which can’t be said about its antiglaucoma component. Some surgeons prefer to combine phacoemulsification with a filtering surgery, or follow the cyclodestructive approach, but taking into account that the main aqueous humor outflow pathway is through the trabecular meshwork, interventions on the Schlemm’s canal are the most relevant and pathogenetically valid. The article covers the main approaches to surgical interventions aimed at the trabecular meshwork in combination with phacoemulsification, and presents surgical techniques developed by the authors.
Фомин, Н. Е. Факторы развития рефрактерной формы первичной открытоугольной глаукомы (часть 2) / Н. Е. Фомин, А. В. Куроедов // Национальный журнал Глаукома. – 2023. – Т. 22, № 4. – С. 68–79.

(Factors in the development of refractory primary open-angle glaucoma (part 2))

 Development of primary open-angle glaucoma (POAG) in older patients is associated with a high risk of its refractoriness, which contributes to the progression of the pathological process possibly leading to a severe disabling complication — blindness. Concomitant pathology also makes a significant contribution to the course of primary open-angle glaucoma and requires a careful approach to diagnosis and management. POAG is a multifactorial pathology, so the treatment plan should take into account both genetic predisposition and general somatic pathology, as well as the socio-economic background. Studying the interaction of these factors contributes to a better understanding of the causes and processes that result in the refractory form of POAG. Specifically, the most common pathologies of the cardiovascular system that affect the course of POAG are arterial hypertension (AH) or hypotension, coronary heart disease (CHD), dyscirculatory encephalopathy (DE). In addition, the course of the disease is significantly affected by diabetes mellitus (DM), neurodegenerative pathologies, and smoking. These findings have been confirmed in a number of international multicenter studies. Certain social factors, however, are of particular importance due to mutually exclusive published findings. Notably, the socioeconomic status of patients (for example, the presence or absence of higher education) also plays an important role in the diagnosis and progression of the disease. Detailed consideration of these factors is extremely important for a better understanding of the disease and, consequently, the improvement of the quality of life of patients.
Повторная хирургия глаукомы: современный взгляд на проблему / А. А. Витков [и др.] // Национальный журнал Глаукома. – 2023. – Т. 22, № 4. – С. 80–88.

(Repeat glaucoma surgery: modern view of the problem)

 Glaucoma surgery is the most effective way to achieve target levels of intraocular pressure. However, it has significant advantages and disadvantages. The main disadvantage is the temporary nature of its hypotensive effect. The onset of surgical failure can occur at various times after the intervention. A correct assessment of the operation timing and risk factors for excessive scarring, as well as correct perioperative therapy, can prolong the effectiveness of the surgery and reduce the number of repeat operations. With a wide choice of surgical treatment methods, trabeculectomy remains the most frequently performed intervention. Its effect is better understood and can be considered more controllable. If the surgical treatment of glaucoma is ineffective, it is possible to prescribe a “restart” therapy, activate previously formed outflow tracts, and perform a second intervention. The development of needling technology makes it possible to delay repeat interventions, prolonging the hypotensive effect of the initial operation.
Юрьева, Т. Н. Особенности репаративного процесса после антиглаукомной хирургии / Т. Н. Юрьева, Ю. В. Малышева // Национальный журнал Глаукома. – 2023. – Т. 22, № 4. – С. 89–98.

(Features of the reparative process after antiglaucoma surgery)

 Excessive fibrosis and scarring of newly created aqueous humor outflow pathways, mainly at the level of the intrascleral canal and filtering bleb, is a significant disadvantage of the so-called bleb-dependent antiglaucoma surgery. Taking into account the fact that aqueous humor, which flows evenly through the non-healing fistula under the hermetically sutured conjunctiva, is the forming substrate for the newly created outflow pathways, its composition also plays an important role in the body’s response to surgical trauma. A large number of publications reliably demonstrate an increase in the concentration of various biologically active molecules in the aqueous humor of the anterior chamber of glaucoma patients. These are transforming growth factor β (TGF-β), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), interleukins IL-6 and IL-8, etc., which concentration in cases of unsuccessful outcome of trabeculectomy was significantly increased compared to patients who underwent successful surgeries. In addition, it has been established that an imbalance of various matrix metalloproteinase pools, fibroblast activation, wound infiltration by neutrophils and macrophages, which in turn express a significant amount of pro-inflammatory cytokines and growth factors, contribute to the prolongation of inflammation and fibrosis. An important condition for the removal of aqueous humor from the filtering bleb area is the postoperative activation of conjunctival lymphatic angiogenesis, which suppression may be associated with prolonged inflammation or the active use of cytostatics. This literature review presents the complexities of the pathophysiological mechanisms of postoperative healing and the formation of newly created aqueous humor outflow pathways after antiglaucoma operations. At the same time, the question remains open about the effect of initial changes not only on the tissues of the ocular surface, but also in the aqueous humor of the anterior chamber, as well as the general condition of patients on the outcome of the operation. The purpose of this review is to present modern literature data on the pathophysiological mechanisms of the wound healing process and the features of postoperative healing regulation after antiglaucoma surgery.
Симакова, И. Л. Современные возможности функционального скрининга глаукомы (часть 1) / И. Л. Симакова, Л. А. Григорян, К. С. Горбачева // Национальный журнал Глаукома. – 2023. – Т. 22, № 4. – С. 99–111.

(Modern possibilities of functional glaucoma screening (part 1))

 Nowadays methods of standard and non-standard computerized perimetry using stationary devices are widely used in functional screening of glaucoma. The information about new portable devices for perimetry has appeared in foreign literature in recent years, describing such advantages as economic availability, autonomy and mobility, which open up new possibilities for their use. New possibilities include cloud storage of data, the use of telemedicine technologies, artificial intelligence, examination of patients with disabilities, including those who are bedridden, as well as examination outside of medical institutions. All of this can allow glaucoma patients to receive ophthalmic care when in-person visits are unavailable, including social distancing needed during a pandemic or quarantine. This review of the literature describes the latest portable devices and applications for perimetry, attempts to classify them according to similar parameters, and assesses their advantages and disadvantages, as well as the prospects for their use in functional screening of glaucoma.
Клинические аспекты различных модификаций кросслинкинга роговичного коллагена / Ю. Н. Юсеф [и др.] // Офтальмология. – 2024. – Т. 21, № 1. – С. 5–15.

(Clinical Aspects of Corneal Collagen Crosslinking Various Modifications)

 The review provides information on methods for cross­linking corneal collagen (КРК), from the time of experimental studies and the first clinical observations to the present. Data are presented on the methods and results of CXL various modifications, as well as on possible promising directions for finding ways to improve the technique to improve functional results and reduce possible complica­tions. Research is currently ongoing not only to improve already proven approaches for CXL, but also to search for new combinations and devices.
Алхарки, Л.  Роль биохимических маркеров в катарактогенезе. Обзор литературы / Л. Алхарки, А. Г. Матющенко // Офтальмология. – 2024. – Т. 21, № 1. – С. 16–22.

(The Role of Biochemical Markers in Cataractogenesis. Literature Review)

 Lens transparency is determined by both cellular and subcellular levels of its organization. Abnormalities of its size, uniformity of shape and correct arrangement of the fibers lead to the scattering of light falling on the lens. At the same time, its normal transparent proteins turn into a cloudy, coagulated, insoluble form, and undergo denaturation. Therefore, the preservation of lens transparency is possible only with a certain chemical composition, achieved by a strict balance of all metabolism links. There are many different hypotheses about the disease etiology. It is known that intraocular fluid has a low content of proteins and an increased concentration of chloride-, lactate-, ascorbatanions in its composition, in contrast to blood plasma. It cannot be ruled out that this is due to the selective permeability of the blood–ocular barrier, which consists of non-pigmented epithelial cells of the ciliary body. In addition, the modification of molecular composition and constitutional imbalance in the intraocular fluid often causes of pathological
processes development in the anterior segment of the eye. The blood-ocular barrier makes the eye an immune-privileged organ. However, many diseases, surgical interventions and eye injuries can lead to blood-ocular barrier damage. This causes to inflammatory effector cells and molecules inducing a cascade of reactions, which in turn results in irreversible fibrotic changes in the lens substance. In this regard, it becomes necessary to search for new reliable methods of determining the level of certain biochemical agents in intraocular structures, as well as establishing reference values for strategically important biomarkers of cataract development. This review presents modern views on biochemical markers imbalance in the anterior chamber aqueous humor and the lens, which contributes to its substance opacity.
Факторы риска прогрессирования неоваскулярной возрастной макулярной дегенерации после хирургии катаракты / В. Г. Лихванцева [и др.] // Офтальмология. – 2024. – Т. 21, № 1. – С. 23–34.

(Risk Factor of Neovascular Age­related Macular Degeneration Progression after Cataract Surgery)

 The prevalence of late AMD, including neovascular AMD or geographic atrophy, and cataract in the same eye after age 80 years is estimated to be 12 and 68 %, respectively. There is currently no consensus on whether cataract surgery is beneficial or harmful for people with dry AMD. Although cataract surgery has been reported to provide better visual outcomes in eyes with AMD 6 months after surgery compared with previously followed eyes, it is unclear whether the timing of surgery relative to the start of AMD treatment influences long-term outcomes. The question of risk factors predisposing to the occurrence of exudation after cataract surgery in people with nAMD remains controversial.
Оганезова, Ж. Г. Генетическая эпидемиология первичной врожденной глаукомы в мире. Часть II / Ж. Г. Оганезова, В. В. Кадышев, Е. А. Егоров // Офтальмология. – 2024. – Т. 21, № 1. – С. 35–43.

(Genetic Epidemiology of Primary Congenital Glaucoma in the World. Part II)

 This publication continues a review published in December 2023 about the genetic epidemiology and genotype-phenotype correlations in primary congenital glaucoma (PCG) worldwide, and presents data from East and South Asia, Western Europe and Russia. Analysis of the incidence of PCG data in these regions shows that the rates for Western Europe, the European part of Russia and East Asia
are comparable and average 1:10,000–18,000 newborns and higher in ethnically mixed groups. On the territory of South Asia, the minimum number of children with PCG was recorded in Nepal, and the maximum in India. The majority of researchers talk about the predominance of bilateral process in 62 to 99 % cases. As a rule, there is a slight predominance of boys among patients with PCG; authors from India and France report approximately the same number of boys and girls, and German scientists have found a higher prevalence of PCG among girls. If we talk about the phenotype of the disease, almost all researchers note a more severe course in subgroups with the presence of CYP1B1 mutations than in patients who do not have a mutation in this gene. As for the genetic causes of PCG, the most common are mutations in the CYP1B1 gene, accounting for up to a third of cases in India, Pakistan, Western Europe and the European part of Russia. In East Asian patients, mutations in the CYP1B1 gene are most likely not the main ones in the
pathogenesis of PCG, because are found much less frequently and often only in one allele. Chinese scientists say that it is necessary to pay attention to mutations TEK and ZC2HC1C, VPS13D, PGF
Морфофункциональные особенности пигментного эпителия сетчатки в норме и при возрастной макулярной дегенерации. Обзор литературы / Р. Р. Файзрахманов [и др.] // Офтальмология. – 2024. – Т. 21, № 1. – С. 44–50.

(Morphofunctional Distinction of Retinal Pigment Epithelium in Normal and Age-related Macular Degeneration. Review of the Literature)

 The retinal pigment epithelium performs a number of highly specialized functions. The relevance of studying morphological changes in the pigment epithelium is associated with an increase in the number of patients with age-related macular degeneration (AMD), polypoid choroidal vasculopathy (PCV), central serous retinopathy and retinitis pigmentosa. The increase in the number of patients with these pathologies is associated both with the general trend of aging of the world’s population and with modern opportunities for mass diagnostics. The pigment epithelium performs a number of functions that ensure the normal functioning of the retina. The main structural unit is a hexagonal epithelial cell with a large number of melanosomes containing the pigment melanin. Pathomorphological changes in the pigment leaf are an important indicator of the development of AMD. In most cases, an elevation or detachment is formed, in which three types are distinguished: druzenoid, fibrovascular (hemorrhagic) and serous. According to a prospective multicenter study, in 19 % of cases, the druzenoid form progresses into atrophy of the pigment epithelium. There are a number of studies that present harbingers of integrity damages. Fibrovascular detachment is the pathomorphological basis for the formation of submacular hemorrhage. The pathogenesis of serous exfoliation in AMD is associated with a range of different mechanisms, ranging from degenerative changes in the Bruch membrane to the formation of choroidal neovascularization. In the scientific publications of a number of authors, information is presented about the complication of detachment in the form of the development of a rupture of the retinal pigment epithelium. The key criterion for a threatening rupture is the height of the pigment leaf detachment. Damage of the integrity of the pigment leaf in the long term is a factor in reducing or complete loss of vision. This is especially characteristic when a gap is formed in the central area of the retina. Also, visual impairment is observed in cases of submacular hemorrhage and the formation of a fibrous scar. An important point, at present, is the development of protocols for the management of patients with ruptures on the background of the underlying disease.
Хван, Д. А. Аберрации высшего порядка – выбор оптимальной интраокулярной коррекции при хирургическом лечении катаракты. Обзор литературы / Д. А. Хван, Г. А. Федяшев // Офтальмология. – 2024. – Т. 21, № 1. – С. 51–57.

(Higher-order Aberrations — the Choice of Optimal Intraocular Correction in the Surgical Treatment of Cataracts. Review of the Literature)

 The cornea is the most powerful refractive element of the eye and plays a fundamental role in the quality of vision. Imperfection of corneas shape leads to the focusing errors formation, known as optical aberrations, which are responsible for visual performance deterioration. Understanding and assessing wavefront errors in IOL selection and calculation is great importance to achieve maximum optical outcome in the postoperative period. The article presents literature data of the effect of higher-order aberrations on the vision quality in unoperated eyes, changes of the wavefront in the eyes after cornea surgical interventions, the effect of various types of IOLs (spherical, aspherical, multifocal and EDOF) on the total error of the eye wavefront, recommendations at their choice with different severity levels of optical aberrations, as well as promising areas of research on this issue.
Сроки применения перфторорганических соединений для тампонады витреальной полости после витрэктомии по поводу регматогенной отслойки сетчатки / Р. Р. Файзрахманов [и др.] // Офтальмология. – 2024. – Т. 21, № 1. – С. 58–65.

(Terms of Use of Perfluoroorganic Compounds for Intraocular Tamponade after Vitrectomy for Rhegmatogenous Retinal Detachment)

 Perfluoroorganic compounds are surgically invasive medical devices, which are represent liquid fluorine-containing substances, chemically and biologically inert and thermodynamically stable due to the strength of chemical bonds between carbon and fluorine atoms. Due to their density, these compounds are able to exert pressure on the detached retina and expel the subretinal fluid. Currently, the use of perfluoroorganic compounds is limited to intraoperative use due to multiplesevere complications of prolonged tamponade. In the analyzed studies, the use of perfluoroorganic compounds as a tamponade was divided into short-term and medium-term tamponade of the vitreal cavity. The authors preferred such tactic for restoring the anatomical fit and a higher rate of aging of retinal laser coagulates, despite proven postoperative complications. Based on the analysis of the results of the presented studies, it can be concluded that it is possible to safely use perfluoroorganic compounds for short-term tamponade of the vitreal cavity. However, among the analyzed domestic and foreign studies, no large-scale statistically significant studies were found to justify the choice of tamponade for retinal breaks different localization, terms of retinal detachment and stage of proliferative vitreoretinopathy. All of that determines the relevance of a more detailed study of the use of perfluoroorganic compounds for short-term tamponade of the vitreal cavity.
Самойлов, А. Н. Биомеханические и топографические особенности роговой оболочки как факторы, влияющие на внутриглазное давление / А. Н. Самойлов, В. А. Усов, Н. Р. Ахметов // Офтальмохирургия. – 2024. – № 1. – С. 78–85.

(Biomechanical and topographic features of the cornea as factors affecting intraocular pressure)

 Today, despite the large number of devices for measuring intraocular pressure, there is no device that could give the value of intraocular pressure, without considering all factors potentially affecting intraocular (IOP) values. Purpose. Conduct an analysis of available literature sources to identify and summarize factors, the consideration of which is necessary to obtain reliable values of intraocular pressure in the clinical practice of an ophthalmologist. Material and methods. To complete the review, literature sources were searched in the PubMed and Scopus abstract databases for the period up to 2022 inclusive using the key words «biomechanical properties of the cornea», «cornea and IOP», «factors affecting intraocular pressure». A total of 58 articles and one clinical recommendation relating to the review topic were selected. Results. The main factors that may influence the formation of IOP values were identified and structured. Groups of factors have been identified, such as: natural, those arising from the use of drugs and other drugs, those arising from medical procedures, diseases, other factors, and those directly related to the anatomy of the eyeball. Conclusion. Thus, after conducting a literature search, we identified and structured the most important factors, ranging from the influence of the external environment to the individual characteristics of human anatomy, the consideration of which is necessary for the correct interpretation and obtaining accurate values of ophthalmotonus in the clinical practice of ophthalmologists. Determining the influence of biomechanical and keratotopographic parameters of the cornea is the most relevant, since in many countries applanation tonometers, such as the Goldmann tonometer and Maklakov tonometer, which are extremely sensitive to the surface features of the cornea, are used to diagnose IOP.
Пономарев, В. О. Перспективы использования наночастиц (квантовых точек) в офтальмологии / В. О. Пономарев, К. А. Ткаченко // Офтальмохирургия. – 2024. – № 1. – С. 86–93.

(Prospects for the use of nanoparticles (quantum dots) in ophthalmology)

 Purpose. A systematic analysis of domestic and foreign literature devoted to the potential use of quantum dots (QD) in ophthalmology, as well as the identification of the main problems regarding the implementation of QD in ophthalmic practice.
Material and methods. To carry out the review, a systematic analysis of scientific publications of domestic and foreign authors was carried out on the resources of PubMed, Medline, eLibrary from 2008 to 2021, devoted to the determination of physicochemical parameters, as well as the practical use of QD. Results. QD-based semiconductor nanoparticles are increasingly entrenched in modern science and medicine, in particular ophthalmology. This review defines the main physical parameters and physical and chemical properties of QD. Their potential applications are wide enough and focused on imaging, drug delivery, electrical stimulation and broad spectrum of anti-infective activity. Conclusion. To date, the existing limitations in the sphere of active QD application in ophthalmic practice are related to fundamental research in the field of acute and chronic cytotoxicity, selection of safe doses and concentrations of QD, working out mechanisms of their delivery, as well as in the study of mechanisms of chemical and biological interaction with the structures of the visual analyzer at dynamically changing physical parameters of QD (shape, size, features of functionalization and silanization). Interdisciplinary interactions between the pillars of fundamental medicine, physics, biology, chemistry, and ophthalmology, in particular, will probably allow us to realize in the nearest five years in clinical practice all the fundamental principles laid down in the previous studies.
Синдром Терсона на фоне острого миелоидного лейкоза (клиническое наблюдение) / А. Л. Жиров [и др.] // Вестник офтальмологии. – 2024. – Т. 140, № 1. – С. 72–78.

(Terson syndrome and acute myeloid leukemia (case report))

 The article presents a clinical case of bilateral Terson syndrome caused by the manifestation of acute myeloid leukemia. A 32-year-old man complained of a sharp decrease in vision in both eyes. Spontaneous subarachnoid hemorrhage occurred secondary to acute myeloid leukemia. Uncorrected visual acuity (UCVA) amounted to OD=0.01, OS=0.005. The anterior segment was normal in both eyes, voluminous immobile white-gray mass measuring 7—9 DD that completely covered the macula (intense hyperechoic cell suspension with a volume of about 1/2 of the vitreous cavity, ultrasound B-scan) were visualized in the posterior pole of the vitreous body of both eyes under conditions of maximum drug-induced mydriasis. Diagnosis: vitreous hemorrhage due to subarachnoid hemorrhage in both eyes secondary to acute myeloid leukemia. Vitrectomy was performed in both eyes. UCVA increased to 0.05 in both eyes. Vitrectomy contributed to improvement of visual functions and patient quality of life.
Маков, И. Н. Роль полноты клинического обследования в безопасности ношения контактных линз для контроля миопии (обзор литературы) / И. Н. Маков // The EYE ГЛАЗ. – 2024. – Т. 26, № 1. – C. 42–47.

(The role of a complete clinical examination for the safety of wearing contact lenses for myopia control (literature review))

 Introduction. In the light of E.S. Avetisov’s hereditary-physiological theory of the pathogenesis of myopia and works devoted to the infl uence of peripheral myopic and hyperopic defocus on refraction, it makes sense to consider myopia as a multifactorial disease, so patients with myopia should receive comprehensive monitoring and treatment from related specialists. However, in practice, the general somatic status of patients and the presence of concomitant diseases in them are often not studied. Purpose: to analyze literature data on the impact of patients’ comorbidities on their wearing of contact lenses, to assess potential risk factors in such patients, and to draw the attention of an ophthalmologist to the importance of a complete clinical examination. Materials and methods. An analysis was made of publications on such resources as Pubmed, eLibrary, Medline over the past 30 years. 43 literature sources were analyzed, of which 37 were published no later than 10 years. Results. The authors of these publications describe how taking drugs from the group of retinoids, the presence of allergic conjunctivitis, thyroid diseases, rheumatoid arthritis, diabetes mellitus, and the characteristics of the patient’s psycho-emotional state can infl uence the incidence of complications when using contact lenses. Conclusions. Taking into account numerous studies on the relationship between the progression of myopia and general somatic diseases, as well as the features of contact correction in childhood with comorbidities, we can say that a complete clinical examination of each patient is of high importance.