Ufa Eye Research Institute

The most modern and effective method of treating degenerative corneal diseases is corneal crosslinking (CXL). This technique involves three steps: epithelial removal, stromal saturation with riboflavin, and UV irradiation at a wavelength of 370 nm. This exposure increases corneal rigidity. Consequently, assessing the impact of this technique on the regeneration and fibrosis processes in corneal tissues is of significant interest. Aim: to study the effect of CXL on rat corneas by assessing TGF-β1 and FGF-1 expression in relation to corneal structural characteristics. Materials and Methods . Experiments were conducted in two groups: Control (intact), Group 2 Experimental, in which a corneal crosslinking technique was performed. This technique involved deepithelialization of a 3-mm-diameter area of the cornea, instillation of DEXTRALINK solution (0.1 % riboflavin mononucleotide and 20 % dextran), and UVA irradiation of the cornea using the “UFalink” device (exposure parameters: 3 mW/cm 2 for 10 minutes at a wavelength of 370 nm). On days 14 and 30, the eyeballs were enucleated and examined using morphological, immunohistochemical (TGF-β1 and FGF-1), and electron microscopy. For statistical analysis, the Mann-Whitney U-test was used to calculate TGF-β1 + and FGF-1 + keratocytes. Results . Mild pathological changes associated with keratocyte destruction in the stroma were detected in the experimental group on day 14. By day 30, however, no such changes were observed in the corneal stromal lamellae. The ultrastructural organization of the cornea, including the lamellae and cellular composition, appeared normal. The expression of TGF-β1and FGF-1-positive keratocytes decreased 14 days after exposure to UV radiation and Dextralink solution, but returned to normal levels after 30 days, matching those of an intact cornea. Conclusions . Corneal crosslinking with DEXTRALINK solution does not lead to the overproduction of TGF-β1 and FGF-1 in keratocytes. On day 14, preservation of the collagen structure of the cornea and the outer and inner epithelial layers was observed, along with signs of destruction and loss of keratocytes. Subsequently, on day 30, keratocytes with signs of increased functional activity were identified.

To assess associations between mortality and major ocular parameters and diseases. The population-based Ural Eye and Medical Study (UEMS) and Ural Very Old Study (UVOS) included 5899 individuals (age: 40+ years) and 1526 individuals (age: 85+ years), respectively. Cause-specific mortality was determined using the government regional information and analytical system. In the UEMS, 689 (11.7%) participants had died during the follow-up of 7.0 ± 0.4 years (median: 6.9 years). Higher death occurrence was associated (multivariable analysis) with lower best corrected visual acuity (OR: 1.86; 95%CI:1.10, 2.68) and higher prevalence of diabetic retinopathy (OR: 2.97; 95%CI: 1.68, 5.26), with adjusting for older age (OR: 1.08), male sex (OR: 4.18), higher waist-hip ratio (OR: 5.53), current smoking (OR: 2.25), history of cancer (OR: 1.93) and dementia (OR: 2.54), higher serum concentration of glucose (OR: 1.13) and lower serum concentration of high-density lipoproteins (OR: 0.89) and haemoglobin (OR: 0.99), higher leucocyte count (OR: 1.07), higher prevalence of chronic obstructive pulmonary disease (OR: 1.67), higher stage of arterial hypertension (OR: 1.15), and higher depression score (OR: 1.04). Death occurrence was not significantly associated with prevalence of age-related macular degeneration (P = 0.90), macular reticular pseudodrusen (P = 0.90), open-angle glaucoma (P = 0.11), angle-closure glaucoma (P = 0.98), nuclear cataract (P = 0.07), cortical cataract (P = 0.46), axial length (P = 0.44) and intraocular pressure (P = 0.87). In the UVOS, 791 (51.9%) participants had died during the follow-up of 4.8 ± 1.0 years (median: 5.2 years). None of the ophthalmological parameters was significantly associated with death occurrence. Diabetic retinopathy was the only major ophthalmic disease or parameter, in addition to vision impairment, which was associated with an increased death risk.

BackgroundUncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020MethodsData from population-based eye disease surveys from 1980–2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12).ResultsIn 2020, 3.7 million people (95%UI 3.10–4.29) were blind and 157 million (140–176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7–30.3) and 2.4% (2.6–2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26–0.40%)) and MSVI (10.3% (8.82–12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295–562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6–76.0) increase from 2000ConclusionsThe number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery.

ObjectivesTo estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by glaucoma and their proportion of the total number of vision-impaired individuals.MethodsA systematic review and meta-analysis of published population studies and grey literature from 2000 to 2020 was carried out to estimate global and regional trends in number of people with vision loss due to glaucoma. Moderate or severe vision loss (MSVI) was defined as visual acuity of 6/60 or better but <6/18 (moderate) and visual acuity of 3/60 or better but <6/60 (severe vision loss). Blindness was defined as presenting visual acuity <3/60.ResultsGlobally, in 2020, 3.61 million people were blind and nearly 4.14 million were visually impaired by glaucoma. Glaucoma accounted for 8.39% (95% uncertainty intervals [UIs]: 6.54, 10.29) of all blindness and 1.41% (95% UI: 1.10, 1.75) of all MSVI. Regionally, the highest proportion of blindness relating to glaucoma was found in high-income countries (26.12% [95% UI: 20.72, 32.09]), while the region with the highest age-standardized prevalence of glaucoma-related blindness and MSVI was Sub-Saharan Africa. Between 2000 and 2020, global age-standardized prevalence of glaucoma-related blindness among adults ≥50 years decreased by 26.06% among males (95% UI: 25.87, 26.24), and by 21.75% among females (95% UI: 21.54, 21.96), while MSVI due to glaucoma increased by 3.7% among males (95% UI: 3.42, 3.98), and by 7.3% in females (95% UI: 7.01, 7.59).ConclusionsWithin the last two decades, glaucoma has remained a major cause of blindness globally and regionally.

Purpose: To evaluate the efficacy and safety of nonsteroid anti-inflammatory drugs (NSAIDs) in monotherapy and as part of combination therapy with glucocorticosteroids for the prevention of postoperative inflammation after cataract phacoemulsification.Material and methods. The study included 75 patients who underwent phacoemulsification with implantation of a posterior chamber intraocular lens. Patients were divided into groups depending on anti-inflammatory treatment: A1 — nepafenac (Nepafenac-Optic), A2 — bromfenac (Broxinac), A3 — dexamethasone (Dexamethasone), B1 — Nepafenac-Optic + dexamethasone, B2 — bromfenac + Dexamethasone. Postoperative inflammation was assessed by the severity of conjunctival hyperemia, pain, Tyndall effect and retinal thickness in the macular region.Results. The severity of the pain symptom was lower in the nepafenac group (A1) as compared to groups A2 and A3 by 49 and 74 %, respectively. A strong direct correlation with the Tyndall effect was revealed, which was more pronounced in group A3 and amounted to 0.73 points. An increase in the thickness of the retina in the macular region in the early stages after surgery was observed in groups A2 and A3, on average by 30 microns. In the groups of Nonpafenac Optic and combined therapy with GCS, the thickness of the retina remained stable. Cystic macular edema in the early postoperative period was observed in groups A2 and A3 and amounted to 2.6 and 1.3 %, respectively. There was a tendency to higher IOP rates in the GCS therapy groups.Conclusion. After surgical treatment of cataracts, the Nepafenac Optic significantly relieves the pain syndrome, as compared with monotherapy with bromfenac or dexamethasone. Nepafenac-Optic helps to reduce the severity of inflammation in the anterior and posterior segments of the eye, minimizes the changes in the retinal thickness of the macular region in the postoperative period. The severity of these effects is comparable to the combination therapy of NSAIDs + GCS. Nepafenac-Optic does not increase IOP, has a more favorable safety profile than in combinations with glucocorticosteroids, and reduces the risk of postoperative complications.

To assess relationships between ocular biometric parameters in dependence of age and sex in children and adolescents. In the Ural Children Eye Study, a school-based cohort study, 4933 children underwent an ophthalmological and general examination. Complete biometric measurements were available for 4406 (89.3%) children. Cycloplegic refractive error (mean: -0.87 ± 1.73 diopters (D); median: -0.38 D; range: -19.75 D to +11.25 D) increased (multivariable analysis; r2 = 0.73) with shorter axial length (β: -0.99; non-standardized regression coefficient B: -1.64; 95% CI: -1.68, -1.59) and lower corneal refractive power (β: -0.55; B: -0.67; 95% CI: -0.70, -0.64), in addition to higher cylindrical refractive error (β: 0.10; B: 0.34; 95% CI: 0.27, 0.41), thinner lens (β: -0.11; -0.85; 95% CI: -1.02, -0.69) and male sex (β: 0.15; B: 0.50; 95% CI: 0.42, 0.57). In univariate analysis, decrease in refractive error with older age was more significant (β: -0.38 vs. β: -0.25) and steeper (B: -0.22 (95% CI: -0.24, -0.20) vs. B: -0.13 (95% CI: -0.15, -0.11)) in girls than boys, particularly for an age of 11+ years. Axial length increased with older age (steeper for age <11 years) (B: 0.22 (95% CI: 0.18, 0.25) vs. 0.07 (95% CI: 0.05, 0.09)). In multivariable analysis, axial length increased with lower refractive error (β: -0.77; B: -0.42; 95% CI: -0.43, -0.40) and lower corneal refractive power (β: -0.54; B: -0.39; 95% CI: -0.41, -0.38), in addition to older age (β: 0.04; B: 0.02; 95% CI: 0.01, 0.03), male sex (β: 0.13; B: 0.23; 95% CI: 0.21, 0.32), higher cylindrical refractive error (β: 0.05; B: 0.09; 95% CI: 0.05, 0.14) and thinner lens (β: -0.14; B: -0.62; 95% CI: -0.72, -0.51). The axial length/corneal curvature (AL/CR) ratio increased until the age of 14 years (β: 0.34; B: 0.017; 95% CI: 0.016, 0.019; p < 0001), and then became independent of age. The AL/CR ratio increased (r2 = 0.78) mostly with higher corneal refractive power (β: 0.25; B: 0.02; 95% CI: 0.02, 0.02; p < 0.001), lower refractive error (β: -0.75; B: -0.05; 95% CI: -0.05, -0.05; p < 0.001), thinner lens thickness (β: -01.6; B: -0.09; 95% CI: -0.10, -0.08; p < 0.001) and older age (β: 0.16; B: 0.006; 95% CI: 0.005, 0.007; p < 0.001). In this multiethnic group of school children in Russia, the age-related increase in myopic refractive error was more significant and steeper in girls, particularly for the age group of 11+ years. Determinants of higher myopic refractive error were longer axial length, higher corneal refractive power, lower cylindrical refractive error, thicker lens and female sex.

Abstract Purpose: Recent histomorphometric and clinical studies suggested that axial myopic elongation occurs through an enlargement of Bruch's membrane (BM) in the retroequatorial and equatorial region, leading to a thinning of choroid and sclera at the posterior pole. Thickness of the retina and choriocapillaris and RPE‐density in the macular region and BM thickness in any region remain independent of axial length. The equatorial‐to‐retroequatorial BM enlargement may be caused by an epidermal growth factor (EGF)‐associated RPE activity. Experimental studies in guinea pigs and monkeys showed a reduction in axial elongation by intravitreally applied blockers of EGF family members and the EGF receptor, and an increase in axial elongation by intravitreally applied EGF family members. In a clinical study, the intraocular EGF amount correlated with longer axial length. It led to the hypothesis, that ocular axial elongation is associated with EGF, and that further axial elongation may be prevented by an EGF blockade. We examined here the safety of intravitreally applied panitumumab, an EGF receptor blocker, already in clinical systemic use in oncology for two decades.Methods: The phase‐1 study included highly myopic adult patients with myopic macular degeneration. The eyes received one to two intravitreal injections of 0.6 mg (60 μl), 1.2 mg (120 μl) or 1.8 mg (180 μl) panitumumab.Results: The study included 10 patients (age 57–72 years, axial length: 29.10 mm–32.67 mm). Examined at day 1, 7, and 28 and at 2 and 3 months after the injections, the injected eyes did not show any intraocular inflammation or morphologic or functional changes, assessed by retinal electroretinography, perimetry, optical coherence tomography, tonometry and visual acuity measurement.Conclusions: The preliminary observations of these 10 patients are in agreement with a notion of an intraocular tolerability of panitumumab repeatedly injected intravitreally in doses of 0.6, 1.2 or 1.8 mg.

Keratoconus (KC) is a progressive degenerative corneal disease, leads to the aberration of biomechanical and optical properties and thinning of the cornea, causes astigmatism and decreases visual acuity.Materials and methods. 33 patients (35 eyes) with stages II–III of non-progressive keratoconus and concomitant cataracts of various stages of maturity were operated on. The average age of the patients was 46.5 ± 2.7 (41–63) years old. The operations were performed according to our proposed two-stage method of treating ametropia in patients with KC and cataracts (Patent of the Russian Federation No. 2748634 of 28.05.2021). The first stage was the implantation of FERRARA intrastromal corneal ring segments (ICRS) with thickness from 150 to 350 μm. To correct residual refractive error in 5–7 months after stage 1, patients underwent stage 2: cloudy lens was removed and replaced with toric posterior chamber intraocular lens (TIOL) – AcrySof IQ Toric (Alcon, USA), T-fl ex Toric RayOne (Rayner, UK).Results and discussion. After stage 1 of the operation (ICRS implantation), the uncorrected visual acuity (NCVA) was 0.2 ± 0.03, the best corrected visual acuity (BCVA) was 0.4 ± 0.02. In 1 month after stage 2 (phacoemulsifi cation + TIOL) NCVA was 0.64 ± 0.11 and BCVA was 0.74 ± 0.12. During the entire follow-up period after the surgery visual functions, refraction, and rotational stability of TIOL were stable.Conclusions. Conducting a two-stage surgical intervention in patients with keratoconus and cataracts allows to stop the progression of the disease and effectively correct the ametropia concomitant with keratoconus.