The species composition of the conjunctival microbiota of newborns and first-year infants informs the selection of an optimal management tactics for the prevention of inflammatory responses. The effectiveness of antimicrobial therapy depends on the availability of susceptibility testing. The most common types of bacteria found in first-year infants include Firmicutes, Proteobacteria, Actinobacteria, Cyanobacteria, and Bacteroidetes. These bacterium types are most sensitive to fluoroquinolones. The bacterial culture of neonates born naturally most frequently contain coagulase-negative staphylococci, Propionibacterium spp, and Corynebacterium spp., while that in neonates born by caesarean section feature coagulasenegative staphylococci, Propionibacterium spp, and Staphylococcus aureus. An examination of infants with neonatal dacryocystitis revealed a high incidence of inflammatory, fungal, and infectious diseases of the genital tract in their mothers. A correlation was established between the bacterial species obtained from conjunctival and cervicovaginal fluid samples. The microflora composition in older infants is characterized by higher complexity compared to that in younger infants. No significant environmental impact is observed in the group of infants under 6 months old. A more complex ocular surface microbiome in childhood is consistent with alterations in the gastrointestinal microbiome. No alterations in the ocular surface microbiome were observed in infants that underwent ophthalmic surgery. The abundance and composition of microflora was found to depend on the geographical location and individual specifics. The conducted research supports the development of a system for monitoring the conjunctival microbiota composition of newborns in obstetric and maternity hospitals. 

This literature review investigates issues associated with the use of laser surgery for preventing visual impairment in patients with retinal vein occlusion. To this end, we analyze publications on the place of laser surgery in the treatment of patients with occlusion of the central retinal vein or its branches, describing the existing spectrum of laser interventions and indications to their implementation in a particular clinical situation. The mechanism triggering retinal vein occlusion was shown to be most frequently thrombosis at the arteriovenous crossing and in area of the lamina cribrosa. The pathophysiology of retinal vein occlusion might lead to a decreased visual acuity as a result of various syndromes. Due to the diversity of developed techniques, laser treatment is widely used for correcting visual acuity in retinal vein occlusion. An effective approach consists in a combination of laser surgery and intravitreal injection of angiogenesis inhibitors or dexamethasone implants. Management of patients with retinal vein occlusion should also involve examination by general practitioners using laboratory and instrumental methods with the aim of etiological verification and systemic therapy. Such characteristics of laser treatment, as high effectiveness and low costs, as well as the possibility of providing outpatient services, determine the popularity of this technology among ophthalmologists and its future prospects. The latter include the maintenance and improvement of visual functions in patients with retinal vein occlusion. 

Keratoconus (KC) is a progressive non-inflammatory ectatic corneal disease typified by corneal thinning and conical protrusion, as well as irregular astigmatism with a varying-degree visual impairment. A literature review on the disease epidemiology, classification and diagnosis is presented. Current clinical practice most commonly relies on the Krumeich’s adaptation of ABCD grading system by M. Belin and M. Amsler. The KC diagnosis requires a comprehensive approach that integrates a variety of methods. Scheimpflug imaging with the corneal biochemistry assessment is performed with a Pentacam Oculus keratotomograph in combination with a Corvis ST device. The result is expressed as diagnostic indices, CBI (Corvis Biomechanical Index), BAD-D (Belin/Ambrósio Enhanced Ectasia Index total deviation) and TBI (Tomographic Biomechanical Index). The use of optical coherence tomography is necessary to perform corneal epithelial thickness mapping as well as pachymetry to rule out hidden stromal thinning. 

This article reviews literature data on the working conditions, labor organization, health and psycho-emotional status, performance, and age composition of teaching staff. Population ageing is a global trend, primarily associated with increased life expectancy and decreased fertility rates. The reviewed publications note a steady increase in the number of elderly people employed in educational institutions of various levels. According to hygienic assessments, the working conditions of teaching staff can be distinguished as potentially harmful. High working, mental, emotional, and voice loads were found to be the key factors affecting teachers’ health, performance, and professional longevity. The accelerating pace of life, growing volumes of circulating information, spreading digitalization and robotization, adoption of online educational technologies  – all these phenomena impose an additional psychological burden on teachers, elderly people in particular, becoming a source of distress and neuroticism. At the same time, the involvement of elderly people in intellectually stimulating professional activities and the respective adequate payment were shown to have a positive effect on the preservation of their cognitive functions and overall quality of life. These findings determine the relevance of investigating the occupational hygiene of elderly teaching staff in order to develop measures aimed at preserving their health, quality of life, and professional longevity. 

This review discusses the principles of constructing epidemiological classifications of infectious diseases. A rationale is provided that taxonomy principles correspond to a combination of morphological and functional approaches. The former covers the shape and symmetry of parasites, while the latter is based on pathogen transmission mechanisms or the ‘function-and-energy’ approach. The idea that pathogen transmission mechanisms are an evolutionary tool implemented in the epidemic process is discussed. Transmission mechanisms are classified into those ensuring reproduction – hereditary, vertical, and contact, those supporting metabolic processes – necrophage, water-soil, and carnivorous for animal and plant infections, as well as those enabling transmission (for animals and humans) – fecal-oral and aerosol. As an example, a hypothetical model of the evolution of viruses based on their transmission mechanisms is substantiated. 

Aim. To evaluate the serum levels of S100b protein, brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in patients with type 2 diabetes mellitus, as well as to establish a correlation between the studied parameters and retinal neurodegeneration.

Methods. In total, 80 patients with confirmed type 2 diabetes (experimental group) and 30 healthy volunteers (control group) were included in the study. All patients were examined using an RTVue-100 optic coherence tomography scanner (Optovue, USA) and a MAIA microperimeter (CenterVue, Italy). The serum levels of S100b, BDNF, and NGF were determined by a sandwich-type solid-phase enzyme immunoassay using reagents produced by R&D Diagnostics Inc. (USA).

Results. The serum level of S100b protein was found to be significantly (p = 0.001) higher in the experimental group, comprising 56.86 (31,12–104,02) pg/ml, compared to that in the control group of 45.19 (37.27–51.79) pg/ml. Conversely, the brain-derived neurotrophic factor (BDNF) showed a significant (p = 0.02) decrease to the level of 27.38 (25.15–29.12) pg/ml in the experimental group compared to the level of 30.19 (27.38–32.14) pg/ml in the control group. The serum level of nerve growth factor (NGF) in the experimental group was found to be 7.53 (5.63–10.54) pg/ml, thereby exceeding significantly (p = 0.02) the level of 5.96 (4.77–8.13) pg/ml in the control group.

Conclusions. The results obtained indicate an imbalance in the serum levels of the studied neuroproteins in patients with type 2 diabetes mellitus and retinal neurodegeneration signs. The identified variations require further research in order to determine the feasibility of their use as additional criteria for predicting the development of retinal neurodegeneration in such patients. 

Aim. To evaluate the effectiveness of products obtained from marine aquatic organisms in the treatment of age-related macular degeneration (AMD).

Methods. In total, 90 patients diagnosed with AMD of various stages were examined. The control group (30 people) received a vitamin-mineral complex containing carotenoids – lutein and zeaxanthin (Retinorm). The 2nd group of patients (30 people) received the Scallop Extract product. The 3rd group of patients (30 people) received the Ascidia Oil Extract in combination with the basic therapy. All patients underwent a comprehensive ophthalmological examination, including optical coherence tomography of the macula and perimetry. The examination was carried out prior to and two weeks after treatment completion.

Results. The experimental group of patients receiving Scallop Extract showed a significant increase in visual acuity indicators after treatment completion. For comparison, the experimental groups of patients receiving Ascidia Oil Extract demonstrated improved photosensitivity indicators and reduced visual field defects.

Conclusions. Addition of marine hydrobiont-based products to the basic AMD therapy is pathogenetically justified due to its positive effects on the maintenance and improvement of visual functions, as well as the light sensitivity of the retina. 

Aim. To investigate the incidence and structure of vascular retinal pathologies in women with preeclampsia and its combination with chronic arterial hypertension (AH).

Methods. A total of 231 medical records of women with different pregnancy histories were studied by consecutive sampling. The first experimental group comprised women (n = 47) diagnosed with preeclampsia combined with chronic AH. The second experimental group comprised women (n = 48) with preeclampsia developed during pregnancy. The first comparison group included women with pregnancy-associated gestational AH. The second comparison group included women with edema and proteinuria during pregnancy but without AH. The control group consisted of women (n = 50) with normal pregnancy histories. The postpartum period ranged from 6 to 12 years.

Results. The development of vascular retinal pathologies during the postpartum period occurred in 28 women in the general sample (12%). Retinal vein occlusions predominated in the structure of vascular retinal pathology (19 women, 19 eyes). Proliferative retinopathy was detected in 8 patients (8 eyes). In one case, a central retinal artery occlusion developed.

Conclusions. The incidence of vascular retinal pathologies in the 1st and 2nd experimental groups comprised 21% and 25% respectively, which was statistically significantly higher than that in the control, 1st and 2nd comparison groups (4%, 4%, and 6% respectively, p < 0.01). The revealed significantly higher incidence of vascular retinal pathology in both experimental groups indicates the domineering role of preeclampsia and AH-associated pre-eclampsia in the development of vascular retinal pathologies. 

Aim. To develop a therapeutic strategy for uveitis complicated with macular edema (ME) based on topical corticosteroids (CS), including sub-Tenon’s administration of CS with subsequent intravitreal injection an Ozurdex implant.

Methods. The examination of 32 patients with chronic recurrent uveitis complicated with ME revealed a correlation between uveitis and the presence of systemic diseases (ankylosing spondylitis, rheumatoid arthritis, etc.). The patients were divided into two groups depending on the selected treatment after completion of the sub-Tenon’s administration of dexamethasone: 1st group – 17 patients with Ozurdex intravitreal implants; 2nd group – 15 patients receiving only dexamethasone instillations. Ophthalmological examination was carried out using optical coherence tomography and microperimetry. The markers of eye inflammation included the total clinical inflammation index and C-reactive protein (CRP) levels in lacrimal fluid (LF). The patients were examined prior to treatment as well as 10 days, 1, 3, 6, and 12 months after the completion of CS therapy. The control comprised functionalmorphological and laboratory parameters of 10 healthy people.

Results. The main intragroup differences were observed one month after the onset of treatment. Patients in the 1st group demonstrated the disappearance of clinical symptoms of uveal inflammation, with the CRP level in LF returning to normal (5.3 ± 0.07 mg/ml) values and differing insignificantly from the control. In these patients, the largest increase in functional parameters compared to the baseline was recorded, with the best corrected visual acuity (BCVA) and eye illumination sensitivity growing by 0.59 and 5.8 dB, respectively. Patients in the 2nd group demonstrated the persistence of some clinical symptoms of uveal inflammation. In these patients, optimal functional and morphological results were achieved three months after the onset of treatment. These results were not only inferior to those obtained in the 1st group, but also proved unstable over longer follow-up periods (6–12 months).

Conclusions. The developed optimized approach of CS therapy for uveitis complicated with ME confirmed its high clinical efficacy: a 3-fold reduction in the duration of uveal inflammation symptoms, a 1.25-fold increase in the frequency of complete ME resorption with the restoration of normal retinal topography in the macula, as well as a 2.2- and 2.35-fold increase in BCVA and eye illumination sensitivity, respectively. 

Objectives. A retrospective analysis of the nosological structure of ophthalmic emergencies based on on-call ophthalmologist reports in 2021.

Materials and methods. A total of 400 people admitted to the emergency room of Territorial Clinical Hospital No. 2 were selected. Data were analysed with MS Excel using descriptive statistics; the results displayed in charts, as well as absolute numbers and the percentage of total cases.

Results. On average, over 10,000 patients with various injuries of the eyeball and adnexa visit the emergency room every year. The patient mean age was 37.4 ± 10.7 years. Unemployed persons or those without formal employment predominated. The injuries were mostly domestic accident. The commonest diagnosis was corneal foreign body (53.5%).

Conclusions. Foreign body was established as the main ocular surface injury (64.75%). Corneal erosions rank second after foreign bodies. Penetrating wounds account for 2.5% cases, comprising the cause of visual impairments as severe as blindness. Preventive measures should be planned and implemented based on the nosological structure identified. 

Aim. To study the frequency and structure of hepatitis and cirrhosis among ophthalmic surgery patients.

Material and methods. Among 1706 ophthalmic surgery patients, 43 patients with chronic hepatitis and cirrhosis were selected. A clinical assessment of the etiology and severity of their condition was carried out and the possibility of performing ophthalmic surgery was determined.

Results. The average age of the patients included in the study comprised 64.1 ± 9.7 years, with 72.1% of the patients belonging to the elderly age group. 88.4%, 9.3%, and 2.3% (one patient) of the patients suffered from viral hepatitis (B, C, chronic HBV and HCV coinfection), toxic hepatitis, and autoimmune hepatitis, respectively. Among hepatitis patients, HCV monoinfection prevailed (55.4%). The majority (97.7%) of patients demonstrated minimal disease activity. Although violations of the hemostatic system were detected in nine patients, signs of significant hypocoagulability were observed in three patients (6.9%). Following a 3-day course of intramuscular vitamin K injections 2 to 3 times per day, these three patients underwent successful ophthalmic surgery. Out of 97.7% of patients admitted to surgery, 39 people were operated in a planned manner and 3 people required medical preparation. In one patient with suspected acute viral hepatitis B, planned surgical treatment was postponed.

Conclusions. The share of patients with hepatitis and cirrhosis in the general structure of ophthalmic surgery patients comprised 2.5%. Among them, viral hepatitis B and C prevailed (88.4%) with dominated HCV monoinfection (55.4%). The vast majority of patients (97.7%) showed minimal hepatitis activity; 6.9% had signs of significant hypocoagulability, thus requiring preoperative medical preparation. 

Aim. To study the localization of NO synthases and apoptosis markers in the nasal mucosa in rhinosinusitis patients with nasal polyps (RNP).

Methods. We studied the biopsy material of nasal cavity polyps and mucous membrane sections of the inferior turbinates of female and male patients aged 35–70 years (n = 70, mean age 57.4 ± 1.52) undergoing surgical treatment in the otorhinolaryngological department of the Vladivostok Clinical Hospital No. 1. The experimental group included polyp materials obtained via polypectomy from patients (n = 50) with a clinically verified diagnosis of nasal polyps without a concomitant pathology of the nasal mucosa. The control group included two variants of nasal mucosa samples. Group I (control I) comprised the nasal mucosa material of patients diagnosed with deviated septum who underwent rhinoseptoplasty (n = 20) without polyposis and concomitant inflammatory and allergic pathologies. Group II (control II) comprised the mucous membrane material of inferior turbinates (n = 50), which was obtained during surgical treatment of patients with a clinical diagnosis of nasal polyps.

Results. It was found that nasal mucosa cells in RNP are characterized by an increased expression of nNOS/iNOS markers, which correlates with the distribution of proapoptotic factors and depends on the clinical and morphological type of polyps.

Conclusions. The development of RNP is accompanied with an increased expression of NOS and apoptosis factors in the nasal mucosa. The specific signal microenvironment provides favorable conditions for the formation of polyps of various morphological types. 

Objectives. A study of the expedience of arthroscopic revision of hip cavity in conjunction with tunnelling, revision and sanitation of the femoral head necrosis site, followed by bone alloplasty early in disease, during surgical treatment of ANFH patients.

Materials and methods. Minimally invasive two-stage decompression with bone alloplasty was performed as a surgical treatment in stage 0, 1, 2 ANFH patients at the orthopaedic unit of Vladimirtsev Territorial Clinical Hospital of Khabarovsk during 2017–2021. The survey included 60 patients examined as follows: clinical examination, radiography, multislice computed tomography and magnetic resonance imaging, with follow-ups in 6 and 12 months.

Results and discussion. A detailed arthroscopy analysis was performed at different stages of the disease sequence, which allowed a comprehensive comparison of X-ray and intraarticular change data.

Conclusions. The study demonstrated that therapeutic and diagnostic hip arthroscopy offers a number of clear advantages and allows decision on a surgical treatment tactics that minimises postoperative complications. The use of minimally invasive surgeries in early ANFH allows a stable regain of the patient social activity to postpone radical surgical interventions. 

Aim. To determine the profile of anthocyanins and optimal parameters of their extraction from Empetrum nigrum fruits.

Materials and methods. Anthocyanins contained in the dried fruits of Empetrum nigrum were identified using HPLC and mass spectrometry. The anthocyanin content was determined using differential spectrophotometry.

Results. Empetrum nigrum fruits were found to contain the following substances: delphinidin, cyanidin, petuinidin, peonidin, and malvidin. The main anthocyanins comprised cyanidin-3-galactose (33.068%), delphinidin-3-galactose (21.733%), and malvidin-3-galactose (15.374%). The necessary conditions for the maximum extraction of anthocyanins from Empetrum nigrum fruits were established to be as follows: the use of 70% ethyl alcohol containing hydrochloric acid as an extrant; a sample weight of 1.0 g; a particle size of 1.0 mm; the 1:70 ratio of raw materials and extractant; an extraction time of 90 min.

Conclusions. The Empetrum nigrum fruits grown in the Kamchatka region were found to contain eight anthocyanins were identified. The anthocyanin content comprised 5.65 ± 0.04%. 

Aim. To assess the local influence of intracranial hemorrhages of various types on postmortem cranioencephalic temperature by means of finite element modeling of the postmortem temperature field of the head.

Methods. The geometry and postmortem heat exchange of human head anatomical structures were simulated using the ELCUT 6.5 software application based on the finite element method, both in the absence and presence of meningeal and intraventricular hemorrhages.

Results. A twodimensional finite element model for determining the postmortem temperature field of the head in the presence of various intracranial hemorrhages under the conditions of convective heat exchange with the air was developed. The absence of a significant direct effect of intracranial hemorrhages on cranioencephalic temperature was confirmed.

Conclusions. Cranioencephalic temperature can be used to determine the postmortem interval in the presence of any intracranial hemorrhages. In order to exclude errors associated with possible hyperthermic death, as well as those caused by local exposure to intraventricular hemorrhages, cranioencephalic temperature should be used to determine the postmortem interval only after its reduction to values lower than 36 °C. 

Malignant glaucoma is one of the most serious complications of eye surgery, which may progress to permanent blindness. The incidence of malignant glaucoma after eye surgery in patients with angle-closure glaucoma ranges from 0.4 to 8%. The article describes the risk factors and clinical manifestations of this pathology and existing treatment approaches. 

The anterior segment mesenchymal dysgenesis is a failure of the normal development of the anterior structures of the eye caused by mutations in the PAX6 gene REIG1, PITX2 and B3GLCT, BMP4, CYP1B1, FOXC1, FOXE3, GJA1, PXDN TP63, and PAX6. Disorders in the structure of these genes or their interactions lead to gross developmental disorders. In this article, we describe a clinical case of an early stepped surgical treatment of Peters anomaly in a child from 1 to 17 years old. According to the presented clinical case and those reported in scientific literature, conservative treatment of this pathology is yet to be developed. At the same time, surgical intervention in the form of penetrating keratoplasty is often fraught with unpredictability and unacceptable postoperative results. 

Age-related macular degeneration (AMD) is one of the major reasons that cause irreversible vision loss among older people. Over the past two decades, vascular endothelial growth factor (anti-VEGF) inhibitors have been successfully used in the treatment of AMD. In this article, we study a new antivasoproliferative agent brolucizumab for the treatment of exudative AMD forms. The drug has demonstrated its high effectiveness in terms of a more rapid onset of therapeutic effect and the resolution of intraretinal and subretinal exudation. 

This article evaluates the first results of operation of the Organizational and Methodological Department (OMD) of the Khabarovsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution during the period 2018–2021. The OMD was established in February, 2019 as part of the Khabarovsk Branch in order to ensure effective interactions between the Branch as a national medical research center (NMRC) and affiliated 3rd level medical organizations situated in the Far Eastern Federal District (FEFD). A number of organizational procedures were implemented, including connection of the NMRC to the Unified State Health Information System, monitoring of the level of ophthalmological care in affiliated medical organizations, identification of bottlenecks in the interaction between the NMRC and affiliated medical organizations, establishment of a system of telemedicine consultations concerning difficult medical cases. Over the period 2018–2021, 32 visits to regional clinics were implemented, 24 knowledge transfer projects were realized, a scientific and educational module “Age-related macular degeneration, dry form” was developed. In addition, the effectiveness of implementation and application of clinical recommendations, including quality assessment criteria for the “Ophthalmology” profile in affiliated medical organizations, was assessed. Over this period, 657 telemedicine consultations were held, as a result of which 23.3%, 73%, and 86.3% of patients were admitted to the Khabarovsk Branch in 2019, 2020, and 2021, respectively. Business relations were established with the senior executive authorities of regions where the affiliated medical organizations are located. The OMD activity during the period 2018–2021 resulted in the establishment of a clear system of organizational and methodological support to 3rd level medical organizations located in the FEFD.