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A clinical case of a severe toxic lesion of the cornea in the form of an extensive ulcer in the only seeing eye (left) due to a prolonged use of the local anesthetic oxybuprocaine is presented. The patient (who had lost the object vision in the right eye after a penetrating injury of the eyeball) started using the drug for the first time on his own accord, without informing the attending physician, 2 months before referring himself to the Ufa Research Institute of Eye Diseases due to the development of recurrent keratoconjunctivitis, accompanied by severe pain. The patient combined oxybuprocaine instillations 4–6 times a day with the prescribed anti-inflammatory therapy, including local application of steroid drops. This led to the development of a corneal ulcer, complicated by a toxic allergic reaction. The fact of a long-term unauthorized use of oxybuprocaine was discovered in a confidential talk with the patient. Subsequent in-patient and long-term out-patient treatment involving reparative, anti-inflammatory, antibacterial and antiviral therapy, helped achieve gradual epithelialization of an extensive corneal defect resulting in vascularized opacification and an increase in visual acuity of the only seeing eye to 0.5 with correction. The case demonstrates the need to increase the awareness of ophthalmologists, who should not disregard possible corneotoxic lesions in their differential diagnosis. In addition, the patients should be informed about severe complications and their consequences associated with self-administration and prolonged use of local anesthetics.

O.I. Orenburkina1,2, A.E. Babushkin3, I.R. Karachurina1 1Russian Center for Eye and Plastic Surgery of the Bashkir State Medical University, Ufa, Russian Federation 2RUDN University, Moscow, Russian Federation 3Ufa Research Institute of Eye Diseases of the Bashkir State Medical University, Ufa, Russian Federation In addition to hereditary, more often bilateral ocular symptoms associated with clinical manifestations such as central corneal opacification (leucoma) with iridocorneal and/or corneolenticular adhesions, Peters syndrome (or Peters anomaly) also represents various systemic abnormalities. Nowadays, variety of conditions termed as Peters anomaly has been extended, and it may include both unilateral and bilateral eye disorders with or without systemic lesions. Iridocorneal and corneolenticular adhesions associated with underlying iris dysgenesis, interrupt intraocular fluid outflow and often lead to concomitant glaucoma complicating the disease course. Oftentimes, Peters anomaly is combined with other congenital visual malformations (e.g., microcornea, aniridia, polar cataract, etc.). Patients with Peters anomalies need early (up to the age of 1 year) surgical treatment (i.e., corneal grafting to restore eye media transparency and to prevent obscuration amblyopia) and anti-glaucoma interventions to reduce intraocular pressure. If mesenchymal dysgenesis and Peters anomaly are revealed, gene and systemic disorders should be identified promptly. As a result, visual acuity will depend on ocular and systemic comorbidities. Keywords: congenital anomaly, Peters syndrome, iris dysgenesis, central corneal opacity, iridocorneal and/or corneolenticular adhesions, glaucoma, corneal grafting, anti-glaucoma interventions. For citation: Orenburkina O.I., Babushkin A.E., Karachurina I.R. Ophthalmological manifestations of Peters anomaly (literature review). Russian Journal of Clinical Ophthalmology. 2024;24(4):–210 (in Russ.). DOI: 10.32364/2311-7729-2024-24-4-7

COVID-19 causes an immunosuppressive condition and increases the risk of secondary infections, including fungal diseases such as mucormycosis (MM), so doctors should be aware of the possibility of MM development in COVID-19 patients. Since no specific complaints or clinical symptoms exist and the disease is rare, especially in developed countries with a moderate climate, it is often impossible to diagnose MM at the initial examination. Therefore, the detection of the pathogen (mycelium zygomycetes) plays a key role in the diagnosis. Over 70 % of MM patients experience eye damages. According to the literature, the most common manifestations thereof are blepharoptosis, ophthalmoplegia, exophthalmos, injection and conjunctival chemosis. Quite often, the patients have eye pains, orbital cellulitis or phlegmon of the orbit, accompanied by a decrease in vision. For the effective treatment of this severe infectious COVID-19 complication, which takes the form of deep and aggressive mycosis, an interdisciplinary approach is necessary. The complex treatment should make use of antimycotic agents and symptomatic therapy, and, essentially, surgical rehabilitation of infection foci by removing the affected necrotic tissues. The prognosis is always very serious.

Nowadays, glaucoma is viewed as a multifactorial neurodegenerative condition that involves many factors affecting different cell types in a human body. As is known, increased intraocular pressure (IOP) is not the only threatening factor of ganglion cell apoptosis and glaucomatous optic neuropathy development; IOP can be associated with other factors, such as vascular, metabolic, neurotrophic, immune, inflammatory, etc. However, the treatment of glaucoma remains largely symptomatic, aimed almost exclusively at reducing IOP. Microbiotic dysbiosis is a newly developing research direction of the glaucomatous progress, showing that this mechanism may turn out to be an important factor of glaucoma development. There are reasons to believe that treatment strategies aimed at microbiota damage correction may contribute to a better efficiency of glaucoma management.

We present a case of carotid-cavernous fistula (CCF) in a 52-year-old female patient who was urgently referred for surgical treatment of a left-sided orbital phlegmon. On the 62nd day after a traumatic brain injury, the patient revealed a visual impairment of the left eye, which was noticeably red and showed a moderate protrusion. The patient’s left orbit was urgently opened and drained.She was undergoing an anti-inflammatory therapy and showed a positive dynamic of the disease, whilst on the 5th day after the procedure, the patient started feeling pain in the left eye and noise in the head. The data of ultrasound examination of the orbit and duplex scanning were largely consistent with a severe massive inflammatory infiltration of the retrobulbar tissue with hypervascularization (the orbital phlegmon could not be excluded). Only a selective computed tomography with angiography helped establish the final diagnosis: arteriovenous malformation in the projection of the supra-sphenoid section of the left internal carotid artery, with post-traumatic CCF on the left. After surgery (endovascular embolization of the CCF), a positive result was observed: with a positive result — no injection or pain in the left eye, exophthalmos gradually regressed. Yet the visual acuity of the left eye was 0.03 due to an atrophy of the optic nerve.Conclusion. The ophthalmologists must be on the alert in cases of unilateral exophthalmos with a history of blunt head trauma, since neuro-ophthalmic symptoms are crucial in clarifying the indications for a prompt implementation of the only surgical treatment effective for this pathology, i.e. endovascular embolization.

During large-scale vaccination against coronavirus infection, studying possible side effects after the introduction of the vaccine is of great practical value. We present a rare clinical case of a complication of COVID-19 vaccine prophylaxis. A 40-year-old female patient was diagnosed with a bilateral adenoviral keratoconjunctivitis complicated by corneal erosion and iritis after a LASIK refractive intervention and a subsequent (after 5 days) immunoprophylaxis with the Gam-COVID-Vac vaccine followed by a displacement of the corneal flap due to involuntary friction of the left eye. The corneal flap was urgently repositioned; its adhesion and stabilization were achieved usinga bandage soft contact lens. The timely local and systemic anti-inflammatory and antiviral therapy allowed achieving a successful visual result (1.0). Ophthalmologists need to remain vigilant about possible adverse effects after immunoprophylaxis on the part of the eye, specifically the conjunctiva and cornea. A timely diagnosis and treatment are important to prevent complications such as persistent corneal opacities that reduce visual acuity, especially in patients who have undergone refractive surgery aimed at achieving the highest possible vision. In our opinion, it is advisable to perform vaccination at least 1 month after the refractive surgery.

The microflora of the ocular surface serves an important role in the protective mechanisms, since it significantly affects the regulation of immunological activity and the barrier effect against pathogen invasion. The presence of a healthy ocular microbiome causes no eye diseases, and ophthalmic pathologies develop only when anatomical barrier functions and immune status are violated. A healthy eye surface is characterized by a relatively stable and small microbiome diversity. The environment, diet, gender, age and some other factors, such as potential contamination, affect the composition of the microbial flora, complicate its analysis and may affect the results of the latter. Moreover, potentially pathogenic organisms various disorders, including inflammation and methods of treating ocular surface can also affect the composition of eye microbioma. Traditional microbiological studies based on cultivation often reveal a rather low diversity of microorganisms in a particular region. New research methods, e.g. genetic analysis based on rRNA sequencing, indicate a much greater diversity than previously assumed. It has been shown that changes in the microbiota composition occur in blepharitis, conjunctivitis, keratitis, uveitis, dry eye syndrome, age-related macular degeneration, diabetic retinopathy, glaucoma, myopia, etc.Currently, there are no clear criteria for describing norms of the ocular microbiome (including fluctuations which should be considered normal during life). The features and impact of the microflora composition on immunity and human body as a whole, in particular, those associated with the intestinal microbiome and their dependence on gender, age, place of residence, etc have not been studied in full.Further studies of eye microbiome can give answers to all these questions.

The work is dedicated to the investigation of the possibility of producing and studying the properties of the thin-walled elements of Diamond-type lattice structures, manufactured from the aluminum alloy AlSi10Mg using the selective laser melting method. The accuracy of fabricating the thin-walled elements was assessed depending on the specified model thickness, power, and scanning strategy. It was demonstrated that the minimum wall thickness with minimal porosity was achieved at a laser power of 260 W and a laser scanning speed of 1500 mm/s. Based on the selected SLM parameters, Diamond-type lattice structures with a wall thickness of 200 µm were produced. Tomographic methods confirmed minimal deviation in the thickness and shape of the lattice structure from the model. Mechanical compression tests were conducted to determine the deformation characteristics, as well as the Young’s modulus, yield strength, and ultimate tensile strength. It was shown that the chosen parameters allow for the production of functional lattice structures.

Abstract Background There is uncertainty regarding the role of obesity in type 1 diabetes development. The aim of this systematic review and meta-analysis was to collect and synthesize evidence regarding BMI and the risk of developing type 1 diabetes. Methods A systematic review and meta-analysis were conducted to assess the association between BMI and incident type 1 diabetes. Databases were searched up to June 2022. Cohort studies were included reporting the association between overweight and/or obesity, as measured by BMI after age 2 years, with incident type 1 diabetes. Independent reviewers extracted data and assessed study quality. Risk estimates were pooled using a random-effects model. Results Ten cohort studies met the inclusion criteria. The seven studies that classified BMI into categories were of high quality and involved 1,690,660 individuals and 1979 incident type 1 diabetes cases. The pooled risk ratio (RR) for type 1 diabetes was 1.35 (95% CI 0.93–1.97) among people with overweight (3 studies); 2.17 (95% CI 1.75–2.69) among people with obesity (5 studies); and 1·87 (95% CI 1.52–2.29) among people with overweight/obesity (two studies merged the categories). These point estimates persisted in sensitivity analyses that addressed the duration of follow-up, variability in baseline risk for incident type 1 diabetes, and potential misclassifications related to exposure or outcome definitions. People with overweight/obesity had a 2.55 (95% CI 1.11–5.86) greater risk for incident type 1 diabetes with positive islet autoantibodies. Conclusion This systematic review and meta-analysis of high-quality observational cohort studies indicated an association between high BMI and the risk of type 1 diabetes, in a graded manner.

Handwriting style is an important aspect affecting the quality of handwriting. Adhering to one style is crucial for languages that follow cursive orthography and possess multiple handwriting styles, such as Arabic. The majority of available studies analyze Arabic handwriting style from static documents, focusing only on pure styles. In this study, we analyze handwriting samples with mixed styles, pure styles (Ruq’ah and Naskh), and samples without a specific style from dynamic features of the stylus and hand kinematics. We propose a model for classifying handwritten samples into four classes based on adherence to style. The stylus and hand kinematics data were collected from 50 participants who were writing an Arabic text containing all 28 letters and covering most Arabic orthography. The parameter search was conducted to find the best hyperparameters for the model, the optimal sliding window length, and the overlap. The proposed model for style classification achieves an accuracy of 88%. The explainability analysis with Shapley values revealed that hand speed, pressure, and pen slant are among the top 12 important features, with other features contributing nearly equally to style classification. Finally, we explore which features are important for Arabic handwriting style detection.

In Russia, Osprey (Pandion haliaetus) nests from the western borders of the Kaliningrad region to the Kamchatka Peninsula, Anadyr River basin, Sakhalin Island, southern Kuril Islands, and Japan. The northern border of its distribution runs along the edge of the northern taiga, forested river valleys in the north. During the Project, the breeding population, migration routes, and wintering sites were determined for the first time for Ospreys inhabiting the north of the European part of Russia, south of Central Siberia (Sayano-Shushenski State Nature Reserve), and in Far East (“Magadan” State Nature Reserve, central part of the Kamchatka Peninsula). After a significant population reduction because of “harmful predators” control and the use of organochlorine pesticides (until the 1970s), Osprey population stabilizes and gradually grows (2–2.5 times in about 30 years) in most regions of the European part of Russia. I

Modern technological make it possible to produce three-dimensional (3D) reinforcement for polymer composite materials. The tasks of experimental research and analysis of the deformation process of new composite materials for aviation purposes taking into account the nonlinearity of mechanical behavior become actual. The paper presents an experimental study of the mechanical compression behavior of composite material specimens made of 3D woven carbon fiber preforms using the pressure impregnation technology (Resin Transfer Molding method with a pairwise interlayer reinforcement and a longitudinal layer). Compression mechanical tests were carried out on specimens using a universal system of electromechanical testing Instron 5882 and a system of 3D analysis of displacement and strain fields on the surface. Tests were conducted in accordance with ASTM D 3410 recommendations and using specialized tooling. Consideration of nonlinearity parameter during experimental data processing is proposed. The importance of determining the values of critical deformation in compression as a parameter characterizing the moment of the beginning of fracture is noted. The comparison of strength, elastic and deformation properties of carbon-fiber composite materials made using the same technology from fibers and binders from different manufacturers is carried out. The experimental diagrams "stress-strain" and their approximating dependences taking into account the nonlinearity function ? are obtained. The type of functions ? of the studied materials is defined, the linear approximation of dependence of functions ? on strain is substantiated. Values of strength limits, elastic modulus, nonlinearity coefficient and critical damage were obtained, statistical processing of the obtained results and their analysis were carried out

O.I. Orenburkina1, A.E. Babushkin2 1Russian Center for Eye and Plastic Surgery of the Bashkir State Medical University, Ufa, Russian Federation 2Ufa Research Institute of Eye Diseases of the Bashkir State Medical University, Ufa, Russian Federation Inherited retinal diseases (IRDs), which are orphan diseases, are a relevant social issue due to severe visual impairment and disability in children and working-age individuals. More than 100 IRDs caused by various defects in about 270 genes are known. Molecular genetic diagnostics is essential for identifying a specific hereditary factor of the disease. One of them is the RPE65 protein that is most highly expressed in the retinal pigment epithelium. Gene replacement therapy (GRT) with single subretinal administration of voretigene neparvovec has already been developed for hereditary retinal dystrophies caused by established biallelic mutations in the RPE65 gene, i.e., Leber congenital amaurosis 2 and retinitis pigmentosa 20. Studies (including domestic ones) have demonstrated a positive effect of this drug, particularly in children. The results of GRT for other neurological disorders have been obtained mostly in experimental studies. However, there are reasons to speak about the prospects of its future implementation in clinical practice. Keywords: inherited retinal diseases, hereditary retinal dystrophies, retinitis pigmentosa, Leber congenital amaurosis, gene replacement therapy, voretigene neparvovec. For citation: Orenburkina O.I., Babushkin A.E. State-of-the-art gene therapy for inherited retinal disorders. Russian Journal of Clinical Ophthalmology. 2024;24(1):41–45 (in Russ.). DOI: 10.32364/2311-7729-2024-24-1-8.

Visual working memory (WM) engages several nodes of a large-scale network that includes frontal, parietal, and visual regions; however, little is understood about how these regions interact to support WM behavior. In particular, it is unclear whether network dynamics during WM maintenance primarily represent feedforward or feedback connections. This question has important implications for current debates about the relative roles of frontoparietal and visual regions in WM maintenance. In the current study, we investigated the network activity supporting WM using MEG data acquired while healthy subjects performed a multi-item delayed estimation WM task. We used computational modeling of behavior to discriminate correct responses (high accuracy trials) from two different types of incorrect responses (low accuracy and swap trials), and dynamic causal modeling of MEG data to measure effective connectivity. We observed behaviorally dependent changes in effective connectivity in a brain network comprising frontoparietal and early visual areas. In comparison with high accuracy trials, frontoparietal and frontooccipital networks showed disrupted signals depending on type of behavioral error. Low accuracy trials showed disrupted feedback signals during early portions of WM maintenance and disrupted feedforward signals during later portions of maintenance delay, while swap errors showed disrupted feedback signals during the whole delay period. These results support a distributed model of WM that emphasizes the role of visual regions in WM storage and where changes in large scale network configurations can have important consequences for memory-guided behavior.

A clinical case of viral conjunctivitis COVID-19, which was complicated by partial symblepharon and severe dry eye syndrome, is presented. The latter was treated for several days with eye drops containing solutions of glucocorticosteroid, a cytostatic and an antiseptic combined with tear replacement therapy, which however led to an extensive detachment of the corneal epithelium of the right eye, a superficial ulcer and an area of keratomalacia in the lower part of the cornea. In view of this, a further hospital treatment was required: the patient received anti-inflammatory and keratoprotective drugs. A subsequent medical consultation found out that the patient had periodically instilled oxybuprocaine hydrochloride 0.4% into the right eye for pain relief for a long time (4 months) without informing the attending physician. As a result of hospital treatment, the condition of the patient’s right eye improved: the corneal ulcer, was epithelialized, followed by the formation of a vascularized corneal leukoma. In our opinion, a deterioration of the tear film stability of the patient, who had had COVID-19 accompanied by ocular manifestations in the form of initially developed conjunctivitis, was due to the anesthetic effect of long-term instillations of oxybuprocaine hydrochloride. This led to a significant decrease in tear secretion, a decrease in the density of goblet cells of the conjunctiva and a violation of the sensory innervation of the cornea, which gradually brought about a severe dry eye syndrome. The above case clearly demonstrates the importance of increasing the patients’ awareness of the harm that could be caused by long-term use of local anesthetics without a doctor’s approval.

Laser-induced fluorescence spectroscopy (LIFS) is actively used for remote sensing of atmospheric aerosols and is currently one of the most sensitive and selective techniques for determining small concentrations of substances inside particles. The use of high-power femtosecond laser sources for LIFS-based remote sensing of aerosols contributes to the development of new-generation fluorescence atmospheric lidars since it makes it possible to overcome the energy threshold for the nonlinear-optical effects of multiphoton absorption in particles and receive the emission signal at long distances in the atmosphere. Our study is aimed at the development and experimental demonstration of the technique of nonlinear laser-induced fluorescence spectroscopy (NLIFS) based on the remote excitation of aerosol fluorescent emission stimulated by a spatially structured high-power femtosecond laser pulse. Importantly, for the first time to our knowledge, we demonstrate the advances in using stochastically structured plasma-free intense light channels (postfilaments) specially formed by the propagation of femtosecond laser radiation through a turbulent air layer to improve NLIFS efficiency. A multiple increase in the received signal of two-photon-excited fluorescence of polydisperse-dyed aqueous aerosols by the structured postfilaments is reported.