PURPOSE. To study the opinions of ophthalmologists on the management strategy for patients with concurrent myopia and glaucoma.
METHODS. This multicenter, scientific-analytical, descriptive, sample-based study was conducted by the "Scientific Vanguard" group of the Russian Glaucoma Society from July to September 2024 through an online survey of Russian ophthalmologists with varying experience, working in healthcare institutions of different ownership types. The developed questionnaire was hosted on a secure online platform. The study involved 302 ophthalmologists, with the overwhelming majority of clinicians (97%) working in the outpatient settings (89%) of state healthcare institutions (85%), with 6–15 years of work experience (48%), without a qualification category (44%), residing in large cities (41%) or cities with a population of over a million (44%).
RESULTS. According to respondents, patients with combined glaucoma and myopia present weekly (48%). Moderate myopia was most common (58%), as well as younger age (70%), advanced stages of glaucoma (55%), moderately elevated intraocular pressure (IOP) (71%), and normaltension glaucoma (58%), which were characterized by rapid progression (52%), absence of complaints (72%), and concurrent cardiovascular conditions (44%). IOP was most often measured using the Maklakov tonometry method (47%). Diagnosing glaucoma in these patients was considered difficult (51%), and ophthalmologists preferred lower target IOP levels (83%), which were harder to achieve (53%). Respondents avoided prescribing m-cholinomimetics (33%) and β-blockers (27%), opting more often for combination therapy (75%). Nearly all believed that these patients require additional neuroprotective treatment (97%). Most respondents considered selective laser trabeculoplasty to be less effective (44%); such patients were operated on more frequently (51%) but with lower success rates (53%) and higher complication rates (60%).
CONCLUSION. Glaucoma patients with myopia are frequently encountered and require careful long-term monitoring and personalized treatment strategies. The early onset of glaucoma and high risk of disability in this group underscore the medical and social significance of the problem and the need for a more detailed study.

PURPOSE. To study the development and progression of stage I-II retinopathy (RP I-II) under the influence of the age factor (AF).
METHODS. A statistical analysis was conducted on a naturalistic cohort of initially healthy 7959 male members of locomotive crews of the Transbaikal Railway aged 18–66 years, observed from 2008 to 2013. The study assessed the development and progression of RP I-II under the influence of AF. Stepwise multifactorial analysis, 2×2 contingency tables, Kaplan–Meier and Cox proportional hazards models were applied. Relative risk was also calculated.
RESULTS. Chronological years (CYs) of life, as indicators of the age factor, produced mutually exclusive outcomes in mathematical models, thus revealing statistical heterogeneity and demonstrating specific identifying characteristics of a trigger factor, by which they can be detected in the cell and their damaging effect studied.
CONCLUSION. The formation of RP differs across specific CYs of life and is determined by the influence of each year as an independent trigger factor. The impact of the AF may also vary across specific ranges. The underlying process of early-stage retinal damage due to aging is the gradual loss of neurovascular structures (NVSs) of the microcirculatory bed (MCB). These findings highlight the need to identify specific quantitative and qualitative ultrastructural and biochemical markers of aging in neural and endothelial cells of the ocular MCB at different CYs of life, which is crucial for restoring normal MCB and retinal function and potentially delaying or reversing age-related diseases before the irreversible loss of NVSs.

PURPOSE. To conduct a comparative analysis of clinical outcomes of repositioning with transscleral suturing of the intraocular lens (IOL) versus a combined approach involving non-penetrating deep sclerectomy with implantation of the Collagen Antiglaucoma Drainage Xenoplast (NPDS+CAD).
METHODS. This study is retrospective analysis of 51 medical records of patients with clinically significant IOL dislocation. Follow-up was conducted on postoperative day 1, and at 1, 3, and 6 months. The following parameters were evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), intraocular pressure (IOP), number of antiglaucoma medications, success rate, and number of complications.
RESULTS. Patients were divided into two groups: group I — IOL repositioning with transscleral fixation (38 patients); group II — combined NPDS+CAD and IOL repositioning with transscleral fixation (13 patients). UCVA and BCVA showed no statistically significant differences between groups throughout the follow-up period (p>0.05). Preoperative IOP was 19.94±7.82 mm Hg and 32.65±11.51 mm Hg (p<0.05); medication load was 0.76±0.94 and 2.69±0.63 (p<0.05) in groups I and II, respectively. At 6 months, IOP was 17.29±5.59 mm Hg in group I (13.3% reduction), and 14.98±6.68 mm Hg in group II (54.1% reduction). Medication load was 1.17±1.68 and 1.54±1.39, respectively. No intergroup differences were observed at 6 months (p>0.05). Complete success was achieved in 33% and 8%, partial success in 33% and 62%, and failure in 14% and 15% of cases in groups I and II, respectively. No cases of shallow anterior chamber were reported in the early postoperative period. There were 4 cases of hyphema ≤1 mm (3 in group I, 1 in group II) and 4 cases of partial vitreous hemorrhage (3 in group I, 1 in group II), all of which resolved on its own. In group I, 4 patients (10.5%) required staged NPDS+CAD within 2.8±4.2 months due to IOP elevation up to 35.5±6.3 mm Hg.
CONCLUSION. The combination of IOL repositioning with transscleral fixation and NPDS+CAD for IOL dislocation in the setting of ocular hypertension demonstrates a high efficacy and safety profile, comparable to stand-alone IOL transscleral fixation in eyes with normalized IOP.

PURPOSE. To evaluate the effectiveness of a novel loading corneal topographic test as a method for objectively determining intraocular pressure levels in the comprehensive diagnostics of glaucoma in young patients with corneal ectasia.
METHODS. Fifteen patients with glaucoma and suspected glaucoma were examined at the Vostok-Prozrenie Eye Center. The average age was 33.9±8.02 years. All patients underwent standard ophthalmological examination and additional methods, including a vacuum-compression test (VCT) with corneal topographic indices recording before and during a short-term induced increase in IOP.
RESULTS. In patients with glaucoma combined with corneal ectasia, the vacuum-compression load with induced IOP elevation revealed biomechanical and topographic changes: decreased corneal hysteresis, decreased IOP values, increased central corneal thickness and curvature, elevated anterior and posterior corneal surface elevation indices.
CONCLUSION. In patients with low corneal hysteresis or fluctuating IOP levels, all patients should undergo corneal topography to detect corneal ectasia, which may lead to underestimation of tonometry results. A stress test with recording of corneal topography during induced IOP elevation can facilitate early detection of glaucoma combined with corneal ectasia in young patients.

PURPOSE. To monitor patients with type 2 diabetes mellitus who developed age-related macular degeneration (AMD) following a COVID-19 infection.
METHODS. The study included 58 patients who underwent a comprehensive examination, they were equally divided into two groups. The main group consisted of 29 patients with type 2 diabetes mellitus and late-stage age-related macular degeneration (AREDS IV) that developed following a COVID-19 infection. In the control group of 29 patients, 12 (41%) had no history of ocular diseases prior to COVID-19, while 17 (59%) had been diagnosed with the dry form of AMD (AREDS I) before the infection.
RESULTS. Central retinal thickness (CRT) correlated with the level of glycated hemoglobin (r=0.80; p<0.05) and C-reactive protein (r=0.43; p<0.05). The mean CRT was 274.3±3.1 μm; best corrected visual acuity (BCVA) — 0.03±0.01; C-reactive protein — 40.03±2.00 mg/L; D-dimer — 150±3.0 ng/mL; and glycated hemoglobin (HbA1c) — 10.6±0.2%. Among study patients, those with elevated levels of C-reactive protein and D-dimer had visual acuity ranging from 0.01 to 0.09, while intraocular pressure remained within normal limits. A favorable trend was associated with a decrease in CRT. The article also presents a clinical case of a patient with AMD, choroidal neovascularization evolving into a fibrotic form, nonproliferative diabetic retinopathy, stage IIIА open-angle glaucoma, a history of partial vitreous hemorrhage, and subretinal bleeding following COVID-19 infection. The hypotensive regimen included a fixed combination of bimatoprost 0.3 mg/mL and timolol 5 mg/mL (Bimokko-SZ), dorzolamide (Dorzolamide-SZ), and brimonidine (Brimonidine-SZ; all medications manufactured by NAO Severnaya Zvezda, Russia).
CONCLUSION. Patients with type 2 diabetes and AMD that developed after COVID-19, accompanied by severe vision loss and elevated biochemical markers of inflammation and thrombogenesis, require regular follow-up and an interdisciplinary approach.

Recent advances in chronobiology have provided new insights into the nature of complex changes in the temporal reorganization of biological processes in the body that occur with aging. The risk of developing and progressing primary open-angle glaucoma (POAG) increases dramatically with age. In recent years, glaucoma has been regarded to as a dysregulatory condition characterized by impaired integrity and hierarchy in the self-regulation and homeostatic systems of the body. The review article presents data from Russian and foreign researchers on the study of chronobiological aspects in the pathogenesis of glaucoma.

The main complication of glaucoma surgery is excessive scarring of newly created aqueous humor outflow pathways. To prevent fibrotic tissue formation, medications with different mechanisms of action are used intraoperatively and during the early postoperative period.
The primary group of anti-inflammatory drugs used in glaucoma surgery are topical steroids. A particularly high antiinflammatory efficacy has been demonstrated with a slowrelease dexamethasone implant placed under the scleral flap.
Nonsteroidal anti-inflammatory drugs, in addition to their direct effect, can potentiate the hypotensive action of prostaglandin analogs and reduce the severity of their local side effects. The use of antimetabolites such as mitomycin C and 5-fluorouracil is justified by their antifibrotic activity, which inhibits DNA synthesis and, consequently, the proliferation of cells including myofibroblasts. However, they are associated with a high risk of hypotonic complications. Angiogenesis inhibitors suppress vascular endothelial growth factor production and thus block proliferation.
The use of ranibizumab, bevacizumab, and infliximab as adjuncts to standard therapy can enhance the longterm effectiveness of glaucoma surgery. However, their use remains limited and not fully explored.

Normal-tension glaucoma (NTG) is a complex form of primary open-angle glaucoma characterized by progressive optic nerve damage despite normal intraocular pressure (IOP) levels.
This review summarizes current concepts regarding the key role of biomechanical factors in the pathogenesis and diagnosis of NTG. Particular emphasis is placed on the structural and functional properties of the corneoscleral shell, including the cornea and sclera, as well as the lamina cribrosa (LC), which determine tissue resistance to mechanical stress. Modern methods for assessing biomechanical properties — such as corneal hysteresis, dynamic tonometry (ORA, Corvis ST), and lamina cribrosa imaging using optical coherence tomography — are of special importance, as they allow the detection of early changes that may not be identified with conventional diagnostic tools.
The review emphasizes the need for further research to standardize biomechanical parameters and develop novel diagnostic approaches, including stress tests. Integrating biomechanical data into clinical practice may improve the early detection of NTG.