Актуальность. Популяционные исследования обнаружили, что распространенность глаукомы в популяции с тиреоидными проблемами составляет 11,9 % против 4,6 % в общей популяции населения. Дефицит тиреоидных гормонов может сопровождаться избытком гиалуроновой кислоты, отеком трабекулярного аппарата и нарушением оттока внутриглазной жидкости. Материалы и методы. Под наблюдением находилось 90 больных (90 глаз) с первичной открытоугольной глаукомой (ПОУГ), которые были разделены на 2 группы. В группу наблюдения вошло 40 пациентов (40 глаз) с ПОУГ в сочетании с первичным манифестным гипотиреозом. В группу контроля вошло 50 пациентов (50 глаз) с ПОУГ без эндокринной патологии. У всех пациентов был проведен анализ морфофункциональных и тонометрических показателей органа зрения, а именно остроты зрения, внутриглазного давления (ВГД), показателей периметрии Humphrey (MD, PSD), показателей оптической когерентной томографии (Area cup/disc ratio, RNFL и Vrim). Результаты. При обследовании больных с ПОУГ и первичным манифестным гипотиреозом было установлено, что показатель остроты зрения составил 0,86 ± 0,12, ВГД — 25,80 ± 5,22 мм рт.ст., показатель MD — –21,3 ± 3,2 dB, показатель PSD — 8,68 ± 1,30, показатель Area cup/disc ratio – 0,87 ± 0,08, показатель RNFL — 60,42 ± 2,5 мкм, показатель Vrim — 0,07 ± 0,01 мм3. Выводы. У больных с ПОУГ и первичным манифестным гипотиреозом отмечается более тяжелое течение глаукомного процесса по сравнению с пациентами без эндокринной патологии. У больных с ПОУГ и первичным манифестным гипотиреозом было установлено статистически значимое (p < 0,05) снижение остроты зрения на 69 %, повышение ВГД на 21 %, уменьшение MD на 187 %, повышение PSD на 119 %, повышение Area cup/disc ratio на 50 %, снижение RNFL на 39 %, снижение Vrim на 100 % при сроке наблюдения 3 года. У больных с ПОУГ без эндокринной патологии статистически значимо (p < 0,05) снижается острота зрения на 26 %, повышается ВГД на 10 %, уменьшается MD на 54 %, повышается PSD на 82 %, повышается Area cup/disc ratio на 39 %, снижается RNFL на 10 %, снижается Vrim на 67 % при сроке наблюдения 3 года.

Introduction. The prevalence and progressive course of myopia is one of the most important medical and social problems worldwide. In recent years, in our country and abroad there is a tendency to increase the incidence of myopia, becoming in some countries an epidemic. In recent years, the most common method of effective control of myopia is the method of refractive therapy with orthokeratological lenses. Objective: To develop criteria for predicting the effectiveness of myopia control using orthokeratological lenses based on individual eye parameters. Object and methods of research. A total of 60 children (117 eyes) were included in the clinical study, who were selected by OKL of combined design, SkyOptix, licensed by KATT Design Group (Canada). The average age was 11 [10; 13], from 7 to 14 years, of which 37 were females (61.7%), 23 males (38.3%). Ophthalmological examination consisted of visometry without correction and with optical correction, autorefractometry on the narrow pupil and in the state of drug cycloplegia, biomicroscopy, biometry, ophthalmoscopy of the central and peripheral fundus, keratotopography of the horns, pupilometry. The results of the research: Among the studied people, the average refractive index at the beginning of the study was -2.25 [-3; -1.5] diopters. The initial diameter of the pupils was determined from 2.78 to 6.30 mm according to the pupilometry performed on the topograph. The average values of eccentricity (Ex) studied in the flat meridian averaged 0.51 [0.47; 0.58], in the steep - 0.53 [0.43; 0.59] at the beginning of the study. In our study, the keratometry of the cornea averaged 43.5 at the beginning of the study [42.7; 44.4]. As a result of probability analysis (increase in APS for two years), the method of construction of logistic regression models was used. We selected five factor features (X): Initial refraction, Pupil diameter (X2), Keratometry (X3), Peripheral corneal force on the reverse zone ring (X4 and X5), Corneal diameter, and Axial length of the eye (APS) at the time of treatment (initial). The equation of logistic regression of the model for predicting the probability of progression of myopia on the background of the use of OKL had the form: The classification ability of the model was determined according to the training sample and amounted to 79.5%. The probability of a true positive result (increase in APS less than 0.3) when using this model was 91.9%, and the probability of a true negative result - 38.5%. Evaluation of the quality of the model using ROC-analysis showed the following: the area under the ROC-curve (AUC) was equal to 0.86 (p <0.001), which characterizes the good quality of the classification of traits. The sensitivity of the model was 82.6%, specificity - 73.1%. As part of the research and mathematical calculations, an interactive WEB application was also developed, which can be accessed from various types of devices connected to the World Wide Web. Modern solutions and approaches used in IT (Information Technology) were used for development. Conclusions. It is determined that when examining a child with progressive myopia, it is important to pay attention to the diameter of the pupil in photographic conditions, because it can be a predictor of progression and influence the choice of correction individually. The smaller the value of keratometry before the appointment of refractive therapy, the greater the value of the size of the APS, so this factor can be indicated as prognostic. The differential topographic force of the cornea along the peripheral ring corresponding to the reverse zone of the lens is a prognostic practical factor. Taking into account the primary parameters of the eye allows you to customize the approach to each child with myopia, improving the individual design of orthokeratological lenses.

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The aim of the study was to identify the features of bacterial keratitis in patients with diabetes mellitus, depending on the severity of diabetic polyneuropathy in complex treatment with eye drops which contain alpha-lipoic acid, citicoline, cyanocobalamine and hyaluronic acid. Materials and methods. 15 patients with type 1 diabetes mellitus and bacterial keratitis were observed. Ophthalmological examination except of standard methods, included bacteriological examination, fluorescein test, noncontact corneal esthesiometry. All patients were treated with instillations of the antibiotic ofloxacin, standard anti-inflammatory therapy, and instillations of eye drops Tioretin A and OMK 2 twice a day locally. Observations were made on the first, third, seventh, tenth, fourteenth, eighteenth and twenty-second days. Results and discussion. In all periods of observation, the severity of conjunctival hyperemia and corneal edema, as well as the size of corneal erosion at the stage of severe complications diabetic polyneuropathy exceeded the corresponding rates of patients with asymptomatic and symptomatic degree. Normalization of conjunctiva color, reepithelialization of the cornea and disappearance of corneal opacification in all patients with severe complications diabetic polyneuropathy occurred 4 days later than in patients with asymptomatic and symptomatic degree. Conclusions. The course of bacterial keratitis depends on the severity of diabetic polyneuropathy: more pronounced violation of corneal innervation is marked at the stage of severe complications diabetic polyneuropathy, which manifested by decrease in its sensitivity, and led to the prolongation of the disease.

Background. Today, the urgent problem is coronavirus disease 2019 pandemic in the whole world. Safety measures such as the use of masks, distance learning have been implemented. However, ophthalmologists, as well as the general population, should know that a face mask together with prolonged use of digital devices leads to an increase in the number of dry eye cases in many patients. The purpose was to study the frequency of dry eye disease in students with myopia. Materials and methods. The study involved 96 medical students diagnosed with myopia taken by random sampling, who were examined by an ophthalmologist. Apart from the standard ophthalmologic examination, all patients underwent the evaluation of the stability of the precorneal tear film by means of corneal topography, and Norn test (tear break-up time (TBUT)). There was also used a standard questionnaire designed to assess the severity of dry eye disease symptoms (Ocular Surface Disease Index). Results. The corneal topography of the 47 patients did not demonstrate any reduction in TBUT. The average time of the concentric ring remained stable for 20.2 ± 3.0 seconds. But 49 individuals exhibited signs of tear film instability over time compared to 47 patients without TBUT impairment. In 47 people without impairments, corneal topography demonstrated that this indicator in Norn test varied from 25 to 18 seconds, i.e. was within the age norm (21.5 ± 3.5 seconds on average). In 3 patients with a minimum TBUT on keratotopography, its value during the Norn test was 9 seconds. In 36 patients with reduced TBUT according to both methods, there was a weak degree of dry eyes, in 10 — moderate, in 3 — severe. The most common complaints were a sandy, gritty sensation in the eyes, visual discomfort when working at a computer and in windy weather, and with prolonged use of a protective mask. Conclusions. Among students who were on distance learning, 51.04 % of individuals have objectively confirmed dry eye disease. People wearing contact lenses have a more pronounced degree of dry eye, so it is mandatory for ophthalmologists to prescribe lubricating eye drops.