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Marfan syndrome is an orphan disease that is caused by a mutation in the FBN1 gene located on chromosome 15 (15q21.1) and is usually inherited in an autosomal dominant manner. The article reviews the results of studies concerning the potential ocular manifestations of Marfan syndrome.

The article presents a clinical observation of visual organ damage as an extrarenal manifestation of thrombotic microangiopathy in malignant arterial hypertension with an analysis of structural and functional changes in the eye by modern examination methods. The presence of renal thrombotic microangiopathy was verified by kidney biopsy. Optical coherence tomography was used to determine structural changes in the inner and outer layers of the retina in the form of their disorganization, areas of thickening of the nerve fiber layer, intraretinal inclusions and cysts, alterations of the ellipsoid zone and retinal pigment epithelium. Optical coherence tomography angiography revealed areas of vascular pattern attenuation in the deep and superficial retinal plexuses corresponding to OCT-detected foci of disorganization of the inner retinal layers. Color Doppler imaging showed absence of the diastolic component of the Doppler spectrum with an increase in the peripheral resistance index RI up to 1.0 in the central retinal artery and posterior short ciliary arteries in both eyes. Functional changes observed with multifocal electroretinography and microperimetry corresponded to the structural changes. Taking into account the similarity of microcirculation in the kidneys and the eyes, the probable pathogenetic mechanism underlying the detected structural and functional symptoms of ischemic damage to the visual organ in malignant arterial hypertension is chronic thrombotic microangiopathy. An interdisciplinary approach to studying thrombotic microangiopathy, including those associated with malignant arterial hypertension, using high-tech examination methods can be useful for timely diagnosis and treatment of this pathology.

Purpose: To evaluate the structure of vitreous body in asteroid hyalosis by low vacuum scanning electron microscopy., Material and Methods: The material of the study was samples of the vitreous body obtained from 7 patients aged from 62 to 72 years with vitreomacular traction syndrome during vitrectomy. In all cases, clinical manifestations of asteroid hyalosis (the presence of multiple point-like echo-positive inclusions) were identified during the preoperative examination. Samples for scanning electron microscopy and chemical microanalysis were prepared without using fixation elements, total dehydration, staining or centrifugation, and according to the so-called principle of bougienage, which consists in partial separation of fractions of the gel-like tissue with a stream of saline., Results: The conducted examinations made it possible to identify various types of local accumulations of mineral elements in the vitreous body in asteroid hyalosis - called asteroid bodies - that is, multiple complex rounded formations consisting of needle-shaped crystals of a radial fibrous structure., Conclusion: The developed algorithm, which includes intraoperative sampling of the vitreous body in conditions of its minimal hydration and a special technique for preparing samples for scanning electron microscopy and chemical microanalysis, provides the capability for the in vivo assessment of morphological changes in hyaloid elements of the vitreous body. With that, asteroid bodies can be considered as markers of the vitreous structures that are difficult to visualize.

Purpose: To analyze intravital structure of the vitreous body in asteroid hyalosis using digital ultrasound imaging., Material and Methods: The study included 64 patients (128 eyes) aged 62 to 73 years with opacities in the vitreous body characterized as asteroid hyalosis., Results: The macrostructure of the vitreous body was evaluated based on the results of digital ultrasound imaging. The analysis covered various types of ultrasound images of the inner projection of the eye and the vitreous cavity. The study demonstrates the possibility of in vivo evaluation of the integrity of vitreous tracts, and the vitreous body as a whole., Conclusion: Ocular ultrasound images of patients with asteroid hyalosis acquired in vivo were used to evaluate the macrostructure of the vitreous body and determine the features of spatial defects.

The article presents a clinical case of Fabry's disease accompanied by changes in the eye and gives detailed description of standard ophthalmological examination and results of some modern methods of assessing macro- and micro-structure of certain ocular tissues. Fabry's disease (also known as Anderson-Fabry disease, diffuse angiokeratoma of the body, hereditary dystonic lipidosis) is a progressive hereditary multi-systemic disease; more specifically, it is a progressive congenital defect in the metabolism of tissues of the human body. It is included in the list of orphan diseases. One of its local manifestations is development of dystrophic changes in the structure of the cornea with tendency to progress. Early diagnosis of Fabry's disease is crucial, but its extensive and 'mixed' symptoms often mask the true causes of pathological changes, which leads to late diagnosis.

The article analyzes existing information on clinical and experimental studies of vitreous changes in asteroid hyalosis, historical aspects of how this condition was studied over the past hundred years, its occurrence and pathogenesis. Results of various studies were used to evaluate current understanding of the forms and elemental composition of phospholipid mineral sedimentation on vitreous structures and methods of its examination. The problem of intravital assessment of the condition of vitreous body was analyzed, and a method was suggested for studying the macrostructure of hyaloid tracts and the state of the vitreous body by means of digital ultrasound in patients with asteroid hyalosis.

Purpose: To analyze the condition of the lacrimal gland in patients confirmed to have sarcoidosis., Material and Methods: The study included 46 patients (92 orbits) with verified diagnosis of systemic sarcoidosis that were examined during the period of 2009 to 2014. The age of patients ranged from 23 to 65 years and the average was 45.1 years. Among the examined patients, 66% were female and 34% male. In all patients, the diagnosis was verified according to modern criteria., Results: Acoustic structure of 46 lacrimal glands of patients with systemic sarcoidosis (92 orbit), and lacrimal glands of 30 healthy individuals (60 orbits) were examined. In-depth in vivo examination of morphological changes was done using 'advanced' analysis of three-dimensional images., Conclusion: The analysis of a large number of studies devoted to changes in the lacrimal glands caused by sarcoidosis revealed a difficult problem: are there any differences between isolated involvement of the lacrimal gland tissue and the defeat of various organs and tissues? For now, the question remains unanswered.

Changes in ocular anatomy and topography that occur due to congenital development anomalies are often of complex, composite nature. Such pathologies are accompanied by not only refractive errors, but also changes in eye's macrostructure. Careful analysis of the changes is necessary to better understand the clinical picture., Purpose: To study the specifics of structural and morphological changes of the eye in certain ocular congenital pathologies and in some orphan diseases using the results of three-dimensional ultrasound analysis and digital acoustic imaging., Material and Methods: The study included 60 patients (119 eyes) with congenital ocular changes, some of which are registered as independent orphan diseases, as well as with systemic manifestations including congenital changes in eye membranes, lens and the vitreous body. The examination involved three-dimensional scanning followed by digital processing of the imaging data obtained using general medical ultrasound systems Voluson 730 Pro Kretz and Voluson E8., Results: Digital ultrasound technologies significantly expand the scope of data on eye morphology in various congenital changes obtainable in vivo., Conclusion: The advantage of this investigation method is the possibility to reliably detect congenital spatially complex morphological deformations in the eye tissues, which in some cases are impossible to observe with other methods.

The review covers general clinical features of particular congenital anomalies of the human eye associated with its abnormal embryonic development. Principal literature sources on evaluation of congenital changes in the vitreous body and identification of its 'underdevelopment' in certain types of congenital cataracts have been studied. The said changes were analyzed with account to general pathology of the human body as well as local morphological manifestations. Covered is the time period from the end of the XIX century to the present. According to the authors, their analysis helps justify the use of digital three-dimensional ultrasound examination for intravital evaluation of congenital changes in the lens and vitreous.

Aim: To analyze changes in various biometric parameters after vitrectomy., Material and Methods: A total of 50 patients (50 eyes) were followed up. All of them underwent vitrectomy for idiopathic epiretinal fibrosis and macular hole. In addition to the standard ophthalmic examination, we performed a combined ultrasound study and ultrasound biomicroscopy before and after the surgery (at 2-3 weeks and 6 months). Variation statistics was applied to assess the results using the SPSS Statistica 20 software., Results: According to ultrasound biomicroscopy, the following parameters increased: anterior chamber depth, trabecular-ciliary process distance, posterior chamber maximal depth and volume, and fiber length within the zonule of Zinn. In the late postoperative period (6 months after the surgery), there was an increase in lens volume and anterior-posterior ocular axis by the average of 0.15±0.04 mm. Against this background, clinical refraction shifted toward myopia by the average of 0.68±0.05 diopters in the early postoperative period and 1.7±0.15 diopters at 6 months., Conclusion: With the help of modern ultrasound examinations we have identified biometric changes in the anterior segment of vitrectomized eyes. We have also established a myopic shift of clinical refraction, which is most likely to be due to the increase in axial eye length and lenticular changes.

This report gives a general overview of embryological features of the human eye. Key literature sources published during the last century on evaluation of congenital changes in the vitreous body and identification of signs of its 'underdevelopment' in certain types of congenital cataracts have been studied. The said changes were analyzed in terms of general pathology of the human body as well as local morphological manifestations. According to the authors, such an approach justifies the need for comparison of clinical manifestations of congenital lens and vitreous changes with possible embryonic defects.

Aim: to investigate the contribution of various hemodynamic disturbances in magistral vessels to optic neuropathy (ON) progression and ocular tension changes in endocrine ophthalmopathy (EOP)., Material and Methods: A total of 39 patients (78 eyes) with subclinical EOP (clinical activity score, CAS ≤ 2) associated with Graves' disease (n = 32, 64 eyes) or autoimmune thyroiditis (n = 7, 14 eyes) were examined. Orbit echography was performed in all patients. Blood flow was assessed with a Voluson 730 PRO ultrasound diagnostic system ("Kretz", Austria) in triplex mode (B-scan, color Doppler flow mapping in combination with pulse-wave Doppler). Thus obtained hemodynamic parameters in ophthalmic artery, central retinal artery (CRA), central retinal vein (CRV), short posterior ciliary arteries (SPCA), and long posterior ciliary arteries (LPCA) were analyzed. To reveal the role of hemodynamic disturbances in the above mentioned vessels in ON progression and eye pressure maintenance, the patients were divided into 7 groups. Only those eyes, whose peripheral indices were increased by more than 25% of normal values and diastolic blood flow decreased by not less than 25%, were selected for further study. Intraocular pressure changes were evaluated by group mean (Mmean = M ± m mmHg), optic neuropathy progression--by the difference in group mean depth (dB) and number of scotomas between the first and the last visit (6 months of observation)., Results: In almost all types of perfusion disturbances, the resultant chronic ocular ischemia causes a decrease in IOP. The only exception, as shown, is simultaneous involvement of CRA, SPCA, and LPCA. The level of blood flow disturbance determines the severity of qualitative and quantitative changes in eyes with EOP-associated ON. The rate of ON progression directly correlates with baseline IOP values on day zero., Conclusion: Long-lasting chronic impairment of blood supply of the eyeball leads to reduction in ocular tension and progression of optic neuropathy. Combined perfusion disturbances in CRA and LPCA as well as in CRA, LPCA, and SPCA can be considered a high-risk factor, while SPCA and/or LPCA involvement--a moderate-risk factor.

Aim: to study the range of structural changes in the vitreous and to determine spatial position of the lens in case of its dislocation., Material and Methods: A total of 47 patients (94 eyes) with so-called senile cataract aged from 59 to 83 years were examined. The state of the vitreous was evaluated by means of digital ultrasound examination., Results: Combined structural changes in the basis and cortex of the vitreous in eyes with lens and/or its elements dislocation have been analyzed. The possibility of lens evaluation in terms of its integrity and topography as well as spatial position of its elements has been shown. The relationship between the vitreous and lens changes has also been established., Conclusion: Digital ultrasound examination is capable of producing a 3D image of the eye, thus, allowing to assess spatial defects of the vitreous and to determine the position of the lens in case of its dislocation.

A clinical case of bilateral retropupillary implantation of iris-fixated lenses (Worst iris-claw intraocular lenses) in a patient with bilateral complete native lens dislocation into the vitreous body is presented. Despite native lens in the vitreous, the patient did not develop ocular hypertension in either eye after the surgery during a long-term follow-up period. Visual acuity significantly improved and there was no necessity in removing the dislocated lenses.

The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

A total of 78 patients (143 eyes) with low, medium and high degree myopia were assessed. Apart from standard ophthalmological tests, flowmetry and duplex ultrasound of ocular vessels were performed in all cases to evaluate volumetric and velocity parameters of ocular blood flow in relation to the length of anterior-posterior axis and the degree of myopia. It is found that both parameters of regional blood flow progressively decrease as the anterior-posterior axis increases.

The study enrolled 39 patients (78 orbits) with verified sarcoidosis. Acoustic analysis of pathological changes in ocular and orbital tissues was performed in all cases. A new evaluation method based on a combination of different modes of digital ultrasound techniques has been proposed. New data on intravital changes in sarcoidosis has been obtained. Formerly unknown deformities of acoustic images of the globe, lacrimal gland, vitreous, optic nerve, and ophthalmic artery, that could be recommended to ophthalmologists and other specialists studying sarcoidosis, have been identified.

Characteristics of ocular blood flow (OBF) in primary open-angle glaucoma (POAG) in eyes with optic disc drusen have been investigated. The study enrolled 21 patient (35 eyes) with optic disc drusen, of which 7 (8 eyes) were diagnosed with POAG. Besides the standard tests, the ophthalmological assessment included evaluation of OBF (flowmetry) and an individual normal range of intraocular pressure (IOP). The results showed that optic disc drusen are not associated with OBF changes. Concomitant POAG might be suspected in a patient with optic disc drusen whose OBF is significantly decreased and IOP is above the individual normal range. Differentiation of morphofunctional changes in chronic optic neuropathy, which might be due to either glaucomatous optic neuropathy or optic disc drusen, is complicated when actual IOP lies within the average normal range. Ocular blood flow evaluation by means of flowmetry with calculation of an individual normal range of IOP has been demonstrated as a highly effective predictor of concomitant POAG in patients with optic disc drusen.

Characteristics of ocular hemodynamics in ischemic optic neuropathy (ION) outcome and normal tension glaucoma (NTG), the conditions that are difficult to be differentially diagnosed, have been investigated. The study enrolled 32 patients (40 eyes) with ION outcome, 26 patients (46 eyes) with NTG, and 20 patients (32 eyes) with no ocular pathology. Besides the standard ophthalmological examination, color Doppler imaging of ocular vessels, evaluation of ocular blood flow volume and individual normal range of intraocular pressure (flowmetry) were performed in all cases. The results showed that an excess of the actual intraocular pressure (IOP) over the individual normal range was much higher in patients with NTG than in patients with ION (39% and 14.5% correspondingly). It was also found that NTG is associated with a more significant decrease of ocular blood flow volume (30.1% in average) in comparison to ION outcome (11%). In both conditions a decrease in velocity parameters of the blood flow in main ocular vessels was registered, however, ocular hemodynamics changes appeared to be more severe in patients with glaucomatous optic neuropathy. A statistically reliable correlation between volumetric and velocity parameters of ocular blood flow has been discovered.

Clinical changes of lacrimal gland (LG) in sarcoidosis are studied. 33 patients (66 orbits) with verified systemic sarcoidosis were examined using digital ultrasound. Different varieties of LG structural changes in sarcoidosis are studied. Different types of LG structural changes were determined in patients with sarcoidosis defined as pseudoedematous and combined forms. Analysis of the results let us reveal characteristic local acoustic changes. Obtained results may be useful for diagnosis of LG changes in patients with sarcoidosis.

Special characteristics of volumetric acoustic digital images of different vitreous and hyaloid membrane changes were studied based on the analysis of results of ultrasound spatial examination of young healthy adults (30 patients) and patients with posterior hyaloid membrane detachment (329 patients). Morphological features of vitreous are presented considering topography and its acoustical structure. Spatial characteristics of planar and volumetric images are determined, special acoustic signs are revealed for normal vitreous and in different changes of posterior hyaloid membrane. These presentations are compared with earlier characterized changes of detached hyaloid membrane. Structural changes of vitreous resulted from posterior hyaloid membrane rapture after blunt trauma or total lens dislocation are estimated.

Complex damage of ocular and orbital structures is an important manifestation of sarcoidosis. Incidence of ocular sarcoidosis varies among the different groups of patients. Nevertheless all patients should undergo specific examination of eye and orbit. Delayed diagnosis of ocular sarcoidosis and improper treatment may result in severe complications. Orbital changes should be also revealed in time and properly evaluated. These are the reasons for searching of new methods of eye and orbit examination in patients with sarcoidosis.

Sarcoidosis is a chronic idiopathic multisystem granulomatous inflammatory disease of unknown etiology. Prevalence of this condition is approximately 3-5: 100 000 with the highest incidence at the age of 25-40 years old and no gender predomination. Early morbidity, disability and severe prognosis worsen patient's condition and make them socially limited. In some cases ocular involvement and vision loss aggravate general condition of the patients. Ocular involvement in sarcoidosis occurs in 10-75% patients. At the same time some data confirm the fact that in 7% of patients ocular damage is the presenting sign making them come to an ophthalmologist whereas orbital involvement may present in systemic disease only. Unclear etiology and clinical similarity with other conditions cause difficulties in early diagnosis and monitoring of patients with sarcoidosis.

The structure of vitreous is discussed in the article. Its morphologic characteristics are described with consideration of topography and structural features. General vitreous anatomy and its distinct compartments are highlighted. Native and foreign literature concerning biological, biochemical and biophysical properties is analyzed. The value of vitreous developmental and structural features in pathogenesis of some pathologic conditions is estimated The parameters of distinct analyzed characteristics essential to form spatial sonographic image are shown.

For the first time vital morphological structure of lacrimal gland was investigated based on spatial ultrasound digital examination. Structural characteristics of lacrimal gland are described considering anatomic topography and blood supply. These characteristics are analyzed based on planar and volumetric sonography depending on the patient age and pattern of changes. Their correlation is studied. The results of lacrimal gland examination allowed us to analyze a number of ultrasound diagnostic signs and compare them with changes in acute dacryoadenitis, MALT-lymphoma, Sjogren disease, sarcoidosis and thyroid eye disease. Revealed features may be useful for understanding of nature of clinical presentation. The results of the study may help to interpret diagnostic signs and follow up their evolution in a clinical course of a disease.

The paper touches upon the specific features of the anatomic structure and biophysical properties of the whole eye and its individual structural elements. The Russian and foreign sources characterizing a wide range of the biological, biochemical, and physical properties of morphological elements constituting the eyeball are analyzed. The significance of individual analyzed characteristics for the formation of a three-dimensional ultrasound image is assessed.

The paper touches upon the specific features of the structure of orbital formations, by considering their anatomic topography and biophysical properties. By studying the results of investigations of the morphological and biophysical studies of orbital tissues, the authors analyze their features and compare their relationships. These results unraveling each of the considered orbital anatomic elements from the acoustic profile ranges may be useful in understanding the nature of clinical changes, which will be able to interpret these or those diagnostic signs--guides and to trace their evolution. In addition, this approach can help interpret the texture of an ultrasound digital image of eye socket soft tissue and permit one to look at pathological clinical manifestations from the so-called biophysical essence. This will allow additional information to be gleaned, by analyzing the usual signs.

Twenty-six patients (45 eyes) (median age 55 years) with optic disc drusen (ODD) (a study group) and 24 healthy volunteers (47 eyes) (median age 53 years) (a control group) were examined. Nerve fiber layer thinning determined by optic coherence tomography (OCT) was found in 65% of the ODD. In 20% of the patients with ODD, nerve fiber layer thinning, as evidenced by OCT, was observed with the normal field of vision, which suggests the higher sensitivity of a morphometric study of the retinal nerve fiber layer. According to OCT data, 11% of the patients with pathological changes in the field of vision had increased retinal nerve fiber layer thickness in some quadrants or from the mean value. These changes may be associated with the large-sized optic disc in these patients.

The study enrolled 63 patients (108 eyes) suspected for optic disc drusen (ODD). ODD were found in 45 patients (83 eyes). Ophthalmoscopic study determined only visible superficial drusen, which accounted for 36.4% of all the found cases. The autofluorescence technique could reveal mainly superficial or shallow drusen in 70.1% of cases and differentiate pseudodrusen. The most reliable and sensitive diagnostic method was B-scanning that determined ODD in 100% of cases. However, B-scanning could not differentiate true drusen from pseudodrusen.

Forty-five patients (83 eyes) aged 17 to 80 years with optic disc drusen (ODD) were examined. Acute anterior ischemic optic neuropathy (AION) was detected in 6% of all the cases. Chronic optic neuropathy (ON) was revealed in 60%, which was predominantly slowly, progressive, asymptomatic and manifested as changes in the paracentral and peripheral fields of vision. Ultrasound study showed small-sized ODD in patients without clinical signs of optic nerve pathology and large-sized ODD in patients with manifestations of chronic ON. ODD affected central retinal artery blood flow (CRABF): in 96.8% of the patients with chronic ON and in 45.5% of those without visual impairments. There was a relationship of the values of the field of vision and CRABF to the extent of ODD.

The review details the basic principles of the optic nerve head circulation. It analyzes the diagnostic capacities of various study methods that are both traditional and proposed and tested in the past decade. The results of Russian and foreign specialists' studies based on Doppler ultrasound study of the ocular artery, short posterior ciliary arteries, and central retinal artery are given.

The review analyzes the implication of ischemia in the pathogenesis of primary open-angle glaucoma. It gives the opinions of leading Russian and foreign specialists who deal with this problem. The basic studies of the morphology of the optic nerve head and its circulatory system are assessed. The specific features of the structure of the orbital arterial system based on the types of ocular arterial branching via formation of intraocular circulation are compared.

The capacities of current ultrasound technologies in determining the extent of intraocular tumors were clinically studied. The proposed algorithm of ultrasound study of intraocular tumors allows for not only making the exact measurements of a neoplasm, but also for determining the three-dimensional configuration of an object within the eye.

The paper presents the results of three-dimensional combined tear ultrasound analysis in various diseases accompanied by the dry eye syndrome. Sixty-five patients with clinical manifestations of the dry eye syndrome were examined. Of them, there were 20 patients with Sjogren's syndrome and disease, 25 with dry eye syndrome of unknown genesis, 5 with lachrymal gland tumorous lesion, 5 with cystic lacrimal gland changes (dacryops), and 10 persons above 65 years of age (a risk group). In each of the study group the study determined the mean sizes of a ultrasound section of the lacrimal gland, its mean volume, and densitometric indices, such as density and vasculogenicity index, as well as the mean values of hemodynamic parameters in the lacrimal artery. The characteristic echographic signs of lacrimal gland structural changes and vascularization are described in Sjogren's disease and syndrome, dry eye syndrome of unknown genesis, dacryops, neoplastic processes involving the lacrimal gland. The proposed algorithm of lacrimal gland ultrasound study can enhance the accuracy and validity of results of the differential diagnosis of various lacrimal gland diseases with the clinical manifestations of the dry eye syndrome. The findings may be further used for the monitoring and detection of three-dimensional and structural changes in the lacrimal gland, which result from various pathological processes with the clinical manifestations of the dry eye syndrome.

The authors present the results of comparison of clinical, instrumental and histological, immunohistochemical and electron microscopic data on two pigment-free ciliochoroidal tumors. Differential diagnosis was made at each of the above stages of diagnosis. There is evidence that despite the similarity of the clinical syndrome, the spindle-cell type of the histological structure of both tumors, the latter were of various histogenesis. This was confirmed by the results of immunohistochemical and electron microscopic studies. Retrospective analysis of the data of immunohistochemical and echographic studies revealed the distinctive signs that could differentiate these two types of tumors at the stage of clinical and instrumental diagnosis.

The paper presents the differential diagnostic signs of choroidal tumors, which are revealed by spatial ultrasound analysis of their angioarchitectonics. An algorithm of a study of the angioarchitectonics of choroidal tumors has been developed on the basis of the current ultrasound technologies that can combine B- and 3D-mode grey scale with energy and color Doppler mapping. Fifty-six patients (58 eyes) with various choroidal neoplasms, including 42 patients with choroidal melanomas, 6 with circumscribed choroidal hemangiomas, and 8 (10 eyes) with metastatic choroidal lesion, were examined. Analysis of the results of the study revealed the specific echographic features of each type of a tumor. The proposed procedure of ultrasound analysis makes it possible to expand the spectrum of the analyzed parameters of the angioarchitectonics, to locate spatially, and to trace the association of the neoplasmic vascular bed with the extraocular circulatory system, which is of great importance in choosing an adequate treatment option.

Early postcontusion hemodynamic disorders were studied, by analyzing the results of color Doppler mapping. The study included patients aged 10 to 45 years with moderate and severe postcontusion retinal changes and a visual acuity of 0.8 to 0.01. Color Doppler mapping was used to visualize blood flow in the ophthalmic artery, central retinal artery, and posterior short ciliary arteries. Preliminary studies revealed circulatory changes in the ophthalmic arterial system in the early postcontusion period. In severe macular and optic nerve lesions, a significant reduction in blood flow was detectable in all the vessels under study, but there was its more pronounced reduction in the central retinal artery and posterior short ciliary arteries, which directly corrected with the found retinal changes since these arteries are the only source of retinal circulation.

The paper presents an algorithm of ultrasound spatial analysis of the unaltered lacrimal gland. The algorithm has been used to define its shape, size, density, structural features and the pattern of blood supply, as well as the anatomic and topographic position in the orbit. The study was conducted in the B- and 3D-modes of color and energy Doppler mapping on both sides. The procedure was based on the clinical examination of 40 healthy individuals aged 20 to 75 years who had no systemic vascular and lymphoid tissue lesions or functional impairments of the lacrimal gland itself. The study defined the mean values of the ultrasound section of the lacrimal gland: 1-1.8 and 0.5-0.8 cm for vertical and horizontal ones, respectively; the mean volume of the lacrimal gland of 0.66 to 1 cm(3) and the densitometric parameters (density and vasculogenicity index); three types of structural manifestations of the unaltered lacrimal gland were identified. The proposed algorithm of ultrasound study of the lacrimal gland may enhance the accuracy and validity of results in the differential diagnosis of various orbital diseases.

The paper presents data on the diagnostic use of three-dimensional (3-D) ultrasound visualization, analyzes earlier existing and new ultrasound diagnostic technologies, and shows it expedient to apply them in ophthalmologic practice. A hundred and forty-six healthy individuals and 52 patients (60 eyes) with different diseases of the eye and orbital cavity (chorioidal melanoma, facial angiomatosis, retinal detachment, vitreoretinal changes, etc.) were examined. The results of the studies and the analysis of the data available in the literature on this problem allow the authors to state that 3-D ultrasound diagnostic technologies can detect occult masses undetectable during conventional visual and ultrasound studies and define the topography of the dislocation of structurally complicated changes in the tunics of the eyeball.

An examination of 40 healthy persons (80 eyes) enabled a refinement and unification of the ultrasound techniques applicable to investigations of a. ophthalmica, a. and v. centralis retinae, a. ciliaris brevis et longae and of other orbital space vessels. Abilities of various regimes of computer-based sonography, in particular of color energy Doppler mapping, were determined in examinations of capillary choroidal plexuses and of optic-nerve portions neighboring directly on the eyeball. The possibilities of using the three-dimension ultrasound angioreconstruction in examinations of the ocular angioarchitectonics and of the retrobulbar space were evaluated.

Preliminary investigations, dedicated to the diagnostic application of three-dimension ultrasonic angioreconstruction, confirmed the feasibility of using the above method in ophthalmologic practice in cases of suspected intraocular and orbital neoplasms. 32 patients (37 eyes) with various pathologies of the eye and orbital cavity, including choroidal melanoma, facial angiomatosis, retinal detachment, chronic uveitis etc.) were examined. The results are indicative of that the three-dimension ultrasonic angioreconstruction makes it possible to detect the latent vascular neoplasms, which cannot be defined by the standard visual and ultrasonic examinations, and the dislocation of structural elements of the eyeball tunics. Besides, it provides for evaluating their special localization and their interrelations with the neighboring anatomic elements.

Historic aspects of ultrasound diagnostics in ophthalmology are described. The technological development of ultrasound diagnostic systems and the clinical application of different ultrasound modes in examining the eye and its choroids are traced back. The efficiency of Doppler mapping in the mode of three-dimension reconstruction at examining the orbital vascular system is evaluated. An experience obtained at the Research Institute for Eye Disease of the Russian Academy of Medical Sciences and outlooks for the diagnostic usage of computer ultrasound in clinical ophthalmology and angiologia are presented.

Super-sharp gray scale image, highly sensitive digital wide-band Doppler analysis, three-dimensional visualization of vessels in pulsed energy Doppler mode, and three-dimensional optic tomography of the optic disk were used in examination of the posterior segment of the eye in 20 healthy volunteers (40 eyes) aged 20-50 years. Vascular network of the optic nerve was examined under clinical conditions; blood filling of elements of the Zinn-Haller arterial circle, reticular plate, and posterior short ciliary arteries were studied. Vascular architectonics of the retrobulbar space was studied by three-dimensional reconstruction in the energy Doppler mode and biometrical parameters of intraocular and retrobulbar part of the optic disk were determined.