The characteristic features of the wound process in the ocular tissues and the effects of drugs that directly affect the formation of connective tissue in the area of intervention are important for understanding and evaluating the prognosis of glaucoma surgery. This experimental study consisted of imitating a glaucoma surgery and evaluating the therapeutic effect of drugs affecting the reparative processes. When assessing the degree of hyperemia in the area of formed filtration blebs as the main prognostic sign of excessive scarring in the postoperative period, its maximum severity was noted with a low tendency to decrease throughout almost the entire follow-up period in the group with the introduction of 5-fluorouracil (5-FU). Morphologically, as the inflammatory process subsided, an increase in the density of fibroblasts was detected in the surgery site, indicating a presence of an active proliferative process. The least amount of local tissue reaction to surgical trauma was noted in the group with 5-FU drug injected in the filtering bleb area in the postoperative period: the absence of inflammatory cells in the stroma, expansion of episcleral vessels and low density of connective tissue cells in the area of surgically formed intraocular fluid outflow pathways. The obtained experimental data indicates a decrease in the activity of scarring processes in the glaucoma surgery site and, consequently, a favorable prognosis of its longterm effectiveness.

One of the relevant tasks in glaucoma treatment is development of a drainage implant (microstent) and a technique for its implantation during minimally invasive surgery with the aim of forming a channel for aqueous humor outflow to maintain patients’ intraocular pressure level within the tolerable range.

We proposed a novel microstent for minimally invasive glaucoma surgery consisting of a drainage tube in the form of a self-expanding frame with dimensions significantly lower than similar devices used in clinical practice. The purpose of this work was to study the safety of the microstent made of nitinol when implanted in the eyes of experimental animals.

The study included 10 grey Chinchilla rabbits divided into two groups. The drainage implant was installed into one eye of an animal, while its second eye was used as control for evaluation of the effectiveness and safety of the microstent. The difference between the groups was conjunctival access; in the second group implantation was done through punctures, moving the knife towards the limbus area.

No inflammatory reactions were observed in cases with implantation of the stent under the conjunctiva and the limbal area. Biomicroscopy showed no differences between animal eyes. No local irritation was found according to morphological criteria.

Microstenting is a promising glaucoma treatment approach, and the present study shows prospects for its continued development and modification of the drainage implant and its delivery system.

Based on the presumption that the average values of ocular rigidity determined ex vivo are sufficient for clinical evaluation of intraocular pressure (IOP), calibration of the Maklakov tonometer is done without taking into due account the biomechanical properties of the tunics of the eye, which can affect the results of IOP measurements. Corneal-compensated IOP (IOPcc) allows evaluating patients' individual structural features of the fibrous tunic of the eye, and according to literature sources, for glaucoma it is a parameter with higher diagnostic value. Comparison of Maklakov tonometer readings and IOPcc from the same patients can improve our understanding of the diagnostic value of tonometry. This article aims to determine based on sufficient clinical data the ranges of corneal-compensated IOP corresponding to applanation tonometry readings performed with a 10-g Maklakov tonometer, and to reveal the dependency between the tip diameter and the IOP with consideration of the variability of biomechanical properties of the fibrous tunic in the population. The comparison study analyzed the readings of 10-g Maklakov tonometer and corneal-compensated intraocular pressure in 14 440 eyes of 7 220 patients (mean age 60.1±10.8 years old) with primary open-angle glaucoma and suspected glaucoma. For analysis, IOPcc values of 6 to 35 were included, with a prerequisite of corneal thickness/ hysteresis data being of high quality. The tip diameter was measured with a Vernier caliper within the accuracy of 0.1 mm according to the instructions from the tonometer manual. It was established that with equal tip diameter the readings of applanation tonometry can still vary significantly, which is associated with population variability in the structure of the fibrous tunic of the eye. A measuring scale was derived consisting of a computation chart with markings denoting the borders of confidence intervals for IOPcc values for 10-g Maklakov tonometer. Mean IOPcc is connected to the applanation tip diameter and the cornea by the following equation: IOP=4.14×D2 -62.4×D+248, which can be used for calibrating Maklakov tonometer in the lower and upper ranges of IOP values. The results of 10-g Maklakov tonometry can be presented as a range of IOP values, which with a certain probability includes the individual IOP level of the patient.

This article presents the preliminary results of a clinical trial of the Individual Intraocular Pressure (IOP) Norm Analyzer. The screening method for determination of individual norm of IOP proved the efficiency for early glaucoma diagnosis, as well as in the treatment and monitoring of the disease. Patients with IOP elevated for up to 15% relative to tolerant IOP were put into the group with low risk of disease development, with IOP elevation of 15 to 25% — the group with average risk, by more than 25% — the group with high risk of developing glaucoma. The Individual IOP Norm Analyzer is an effective device for dynamic monitoring, which in combination with other examination methods increases the capabilities of early diagnosis, monitoring of glaucoma with regard to individual parameters.

Artificial intelligence (AI) is rapidly entering modern medical practice. Many routine clinical tasks, from imaging and automated diagnostics to robotic surgery, cannot be imagined without the use of AI. Neural networks show impressive results when analyzing a large amount of data obtained from standard automated perimetry, optical coherence tomography (OCT) and fundus photography. Currently, both in Russia and abroad mathematical algorithms are being developed that allow detection of glaucoma based on certain signs. This article analyzes the advantages and disadvantages of employing artificial intelligence in ophthalmological practice, discusses the need for careful selection of the criteria and their influence on the accuracy of calculators, considers the specifics of using mathematical analysis in suspected glaucoma, as well as in an already established diagnosis. The article also provides clinical examples of the use of glaucoma risk calculator in the routine practice of an ophthalmologist.

Purpose of this study — to compare the results of different tonometry methods before surgical treatment of glaucoma and in the early postoperative period.

The study was conducted on a group of 50 patients (50 eyes) aged 55 to 80 years with uncompensated primary open-angle glaucoma, who were admitted to in-patient department for glaucoma surgery. Patients were examined using bidirectional applanation tonometry of the cornea performed on Ocular Response Analyzer, pneumotonometry on Canon TX-20P device, and with Icare tonometer. These studies were carried out on the day before the surgery, the next day, and 2 weeks after the operation.

Significant differences in tonometry readings were revealed between all tested devices at high intraocular pressure (IOP) levels (before glaucoma surgery). Significant differences were also found in IOP values obtained with Icare tonometer in the central zone of the cornea and in the middle periphery in the nasal and temporal sectors. A significant difference between the indicators remained on the next day after surgery, except for the Icare readings. After two weeks, the tonometric parameters did not differ significantly from each other.

Corneal compensated IOP (IOPcc) is the most important tonometric indicator in clinical practice because it takes into account the individual biomechanical characteristics of the patient’s cornea. When examining patients with glaucoma, the IOPcc indicator significantly differed in uncompensated IOP, which is important for determining the correct treatment tactics. When assessing the level of IOP after surgery this trend persisted, indicating a systematic underestimation of IOP level (overestimation of the effect of glaucoma surgery). The reliability of the study is confirmed by the results of measurements on unoperated fellow eyes (control).

PURPOSE. To identify clinical and epidemiological features of the course of primary open-angle glaucoma (POAG) in patients with a verified family history of the disease.

METHODS. The study protocol included data from 103 people (103 eyes), among them 37 (35.9%) men and 66 (64.1%) women. Group 1 (44 people, 44 eyes) included patients with sporadic glaucoma. Group 2 consisted of patients with a hereditary form of the disease (41 people, 41 eyes). Healthy individuals (18 people, 18 eyes) comprised the control group. Mean age of all patients at the time of final examination was 60.6 (56.0; 66.3) years. In all cases, the diagnosis was established in accordance with the system of differential diagnosis of diseases. Examination was always carried out in person and included routine and specialized study methods (static automated perimetry, optical coherence tomography, examination of the thickness of the cornea in the central optical zone).

RESULTS. The mean age of patients with a family history at the time of POAG diagnosis was 59.8 (53.9; 63.1) years, in patients with sporadic glaucoma — 63.85 (58.5; 67.9) years. Therefore, POAG in the group with a family history was diagnosed 4.05 years earlier. No significant differences in the structural and functional characteristics of the visual analyzer were established. A greater number of patients with the sporadic form of the disease undergo glaucoma surgery (47.7% and 34.1%, respectively) in comparable disease duration.

CONCLUSION. In people with a family history of glaucoma, preventive screening should be carried out at an earlier age than the average in the population.

Neuroprotection is a direction in therapy that prevents the loss of neurons due to external factors. In glaucoma, the use of both direct and indirect neuroprotection is pathogenetically justified, which, respectively, can have a direct protective effect on retinal ganglion cells, or affect various risk factors for the development of neuropathy. At present, Retinalamin — a complex of peptides isolated from cattle retinas — is used in ophthalmology for neuroprotective purposes. Although the clinical efficacy and safety of Retinalamin is well established, its exact mechanism of action remains unclear. To amend this, in vitro studies of its cytotoxicity and efficacy were carried out, as well as a comparison of its effectiveness in various ways of administration, and a retrospective analysis of its use.

PURPOSE. To identify the predictors of increased intraocular pressure (IOP) after intravitreal injection (IVI) of an antiVEGF drug using anterior segment optical coherence tomography (AS-OCT), and to study changes in the iris-lens diaphragm produced by multiple injections in the treatment of neovascular form of age-related macular degeneration (nAMD).

METHODS. IOP was measured with an ICare Pro tonometer before IVI, 1 minute after IVI, 30 minutes, 60 minutes and 180 minutes later. Anterior chamber depth (ACD), anterior chamber angle (ACA), and lens thickness were assessed using Revo NX tomograph (Optopol, Poland). The study was carried out before IVI, one month after the first IVI, one month after the third IVI, one year after the start of treatment. Axial length was measured once before IVI.

RESULTS. An inverse correlation was found between axial length and an increase in IOP 1 min after IVI (r=0.65, p<0.001). According to AS-OCT data, one year after the start of treatment there was a significant decrease in ACD compared to the data before treatment (p><0.001), as well as a decrease in all parameters of ACA (p><0.05). Shorter axial length (R2 =0.45, p><0.05), shorter ACD (R2 =0.44, p><0.05), smaller ACA on the nasal (R2 =0.37, p><0.05) and temporal (R2 =0.39, p><0.05) sides in patients with their own lens led to a greater rise in IOP 1 min after IVI.

CONCLUSION. Predictors of a sharp increase in IOP after IVI of an anti-VEGF drug in patients with nAMD that can be detected with AS-OCT are shorter ACD and smaller ACA. The following prognostic model was determined — with a 1-mm decrease in the axial length, an increase in IOP by 2.3 mm Hg should be expected, a decrease in ACA from the temporal side by 1° leads to an increase in IOP of 0.28 mm Hg>

In 2013, at the 9th Congress of the World Glaucoma Association, a new classification of childhood glaucoma was adopted.

PURPOSE. This study analyzes the profile of childhood glaucoma in accordance with the new classification and evaluates the convenience of its use in clinical and research work.

METHODS. We reviewed the retrospective data of 652 patients (1000 eyes) aged 0 to 18 years with childhood glaucoma who were under observation between 2002 and 2022. The mean follow-up period was 10.4±0.2 years.

RESULTS. The majority of patients had bilateral glaucoma (53.4%). The most common are bilateral manifestations in primary congenital glaucoma (79.7%), juvenile glaucoma (95.8%), secondary glaucoma associated with nonacquired ocular anomalies (54%). The majority of patients in the study were male (363 patients; 56.7%). The most common diagnoses were secondary glaucoma associated with acquired conditions (42.6%), primary congenital glaucoma was diagnosed in 21% of cases. In the vast majority of cases (from 52% to 85%), the treatment of glaucoma was surgical. The maximum number of repeated hypotensive interventions (2.1 operations per eye) was required for patients with primary congenital glaucoma. The results of surgical treatment of secondary childhood glaucoma turned out to be more optimistic — one operation was enough to control glaucoma in 64.6% (62 eyes out of 96) of operated eyes with glaucoma associated with non-acquired ocular anomalies, in 70.7% of cases (29 eyes out of 41) in glaucoma associated with non-acquired systemic conditions, 66.8% in secondary glaucoma associated with acquired conditions (227 eyes out of 340), and in 68.4% of cases in glaucoma following cataract surgery (39 eyes out of 57). In the course of the observation period, 1239 glaucoma interventions were performed. The intervention of choice in all subgroups was filtering surgery. Cyclodestructive procedures were performed significantly more often (p<0.05) in the group with secondary glaucoma associated with acquired conditions. CONCLUSION. The use of a unified classification system is expected to greatly enhance the understanding of this disease, and consequently improve childhood glaucoma management approaches and standards of clinical care in rare types of this disease.>p<0.05) in the group with secondary glaucoma associated with acquired conditions.

CONCLUSION. The use of a unified classification system is expected to greatly enhance the understanding of this disease, and consequently improve childhood glaucoma management approaches and standards of clinical care in rare types of this disease.