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It is considered, that one of the main directions of treatment of adenovirus conjunctivitis is the appointment of interferon alpha-2b in combination with diphenhydramine, which until recently was provided by the only original drug. In 2020, the first generic drug, Interferon-Oftalmo, would be registered in Russia.The purpose: to evaluate and compare the efficacy, safety and tolerability of treatment of patients with keratopathy against the background of adenovirus keratoconjunctivitis with Interferon-Oftalmo and Oftalmoferon.Material and methods. The comparative analysis included completed cases of treatment of 51 patients (102 eyes) aged 18–75 years with clinical signs of keratopathy against the background of epidemic adenoviral keratoconjunctivitis. Patients of the first group (n = 27, 54 eyes) on the background of tear replacement therapy received eight instillations of the drug Interferon-Ophthalmo, the second (n = 24, 48 eyes) received Oftalmoferon. The observation period was 15 days. Treatment efficacy was assessed based on a quantitative analysis of the dynamics of clinical symptoms of inflammation and the state of the cornea, the severity of subjective manifestations of ocular surface xerosis using the ocular surface damage index (OSDI), as well as the stability of the tear film. Safety and tolerability were also evaluated.Results. Against the background of complex therapy, which included the instillation of Interferon-Ophthalmo or Oftalmoferon, all patients showed comparable dynamics in the relief of the inflammatory process and keratopathy. This was expressed in a statistically significant decrease in the severity of foreign body sensation, lacrimation, itching, eyelid edema, conjunctival edema and hyperemia, follicular reaction, conjunctival hemorrhages, punctate keratopathy, subepithelial infiltrates in the cornea. In both groups, there was a steady downward trend in OSDI against the background of an increase in the stability of the tear film and an increase in maximally corrected visual acuity. The safety and tolerability profile of the drugs was assessed as comparably favorable.Conclusion. The inclusion of the drug Interferon-Oftalmo in the complex therapy of adenoviral epidemic keratoconjunctivitis allows us to expect a comparable effect on the course of the disease compared to the original drug Oftalmoferon.

Inherited retinal dystrophies (IRD) include a wide range of genetically and phenotypically heterogeneous diseases that lead to progressive loss of vision. With the development of gene therapy, it has become possible to treat two forms of IRD caused by biallelic mutations in the RPE65 gene: isolated retinitis pigmentosa (IRP) type 20 and Leber's congenital amaurosis (LCA) type 2. These nosologies are included in the list of orphan diseases of the Russian Ministry of Health. The success factor for the use of IRD gene therapy is the early stage of the disease, when the viability of retinal cells is preserved. An interdisciplinary approach to diagnostics makes it possible to timely establish the clinical and genetic variant of IRD and refer the patient to targeted therapy. Therefore, at a joint meeting of the Council of Experts of the North-Western Federal District of the Russian Federation, which included ophthalmologists and medical geneticists, a scheme for managing patients with IRD was accepted, including the stages of clinical and functional ophthalmological examination and molecular genetic testing. In addition, regional centers of expertise for IRD were approved in two federal medical institutions in St. Petersburg, whose task is to optimize the quality of diagnosing patients with IRP and LCA.

The problem of drug therapy for bacterial eye infections in children has remained relevant for many years. The greatest interest of ophthalmologists in recent years is associated with the use of fluoroquinolones in the treatment of inflammatory eye diseases of the bacterial etiology. At the same time, new ophthalmic dosage forms of fluoroquinolones that have appeared in recent years naturally require additional research on their effectiveness.Objective: to study the clinical efficacy of the antibacterial drug Oftocypro (0.3 % cyprofloxacin in ophthalmic ointment) in the treatment of chronic blepharoconjunctivitis in children.Materials. The study involved 38 children aged 3 to 18 years (mean age 10.3 ± 2.7 years) with clinical manifestations of blepharoconjunctivitis. All patients were divided into 2 groups of equal size: 18 children (36 eyes) — with bacterial blepharoconjunctivitis and 20 (40) — with chlamydial blepharoconjunctivitis. The diagnosis was verified based on the clinical picture of blepharoconjunctivitis and laboratory data: detection of pathogenic microflora in the conjunctival cavity of patients of the first group and chlamydia antigen — in epithelial cells in scraping material from the conjunctiva by immunohistochemical analysis.Results. The analysis of the data obtained during the examination and treatment of children with blepharoconjunctivitis of bacterial etiology (group I), a reliable dynamics of controlled clinical and laboratory parameters was established. There was a significant positive dynamics of all controlled parameters of the clinical course of chronic bacterial blepharoconjunctivitis against the background of the drug Oftocipro ophthalmic ointment 0.3 % use. All children with chronic chlamydial blepharoconjunctivitis with the background of treatment with Oftocypro, ophthalmic ointment 0.3 %, showed a steady tendency towards relief of the estimated clinical signs of the disease. According to the results of laboratory studies, it was found that on the 28th day of treatment with Oftocypro chlamydia in the cells of the epithelium of the conjunctiva was re-detected in 4 out of 20 patients (20 %).Conclusion. The high efficacy of the drug Oftocypro ophthalmic ointment 0.3 %, in combination with the absence of pronounced side effects, makes it possible to recommend this drug for wider practical use.

The aim of the study was to evaluate the effectiveness of the preparations Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) in the treatment of children with dry eye syndrome (DES) and to determine the indications for prescribing these drugs for various etiologies and clinical course of the disease.Patients and methods. The study involved 56 children aged 4–17 years with DES, which were divided into 3 groups, depending on its pathogenetic type. The first consisted of 24 children with DES, which developed on the basis of chronic blepharitis, the second — 12 children with neuroparalytic keratitis, and the third — 18 children with chronic uveitis, in whom DES was caused by prolonged instillations of eye drops with benzalkonium chloride. Each group was divided into 2 more equal subgroups, the first of which was prescribed the drug Optinol® Express Moisture, and the second — Optinol® Deep Moisture with a frequency of 4 times a day.Results. In all children, from the very first days of instillation of the studied drugs, a decrease in the severity of subjective signs of DES (OSDI) was noted, as well as a gradual decrease in the degree of xerotic changes in the ocular surface (severity of its staining with vital dyes) and an increase in the stability of the tear film (M.Norn). At the same time, the positive dynamics of the controlled parameters increased with the continuation of therapy, reaching a maximum by the 30th day of treatment. Moreover, the effectiveness of therapy depended on the severity of xerosis of the ocular surface: it was maximal in children with mild, and minimal in children with an extremely severe form of xerosis (with neuroparalytic keratitis). Moreover, the drug Optinol® Express Moisture was more effective in the treatment of children with mild and extremely severe forms of DES, and Optinol® Deep Moisture — with moderate and severe xerosis.Conclusion. The preparations Optinol® Express Moisture and Optinol® Deep Moisturization are effective in the treatment of children with DES, which has developed on the basis of pathology of the ocular surface of neurotrophic and artifact genesis, as well as increased volatility of the precorneal tear film against the background of chronic blepharitis.

The purpose: to evaluate the effectiveness of the Delfanto® in the complex therapy of patients with dry eye syndrome of various etiologies and severity of the clinical course.Patients and methods. 114 patients (228 eyes) with dry eye syndrome of various etiologies were examined: 72 patients with chronic meibomian blepharitis and dysfunction of the meibomian glands (xerosis due to increased evaporation of the tear film), 33 women with perimenopause (a mixed form of xerosis with a predominant decrease in the production of components of the tear film) and 9 persons with Syegren syndrome (xerosis due to a pronounced decrease in tear production). All patients received individually selected tear replacement therapy over the past weeks and the drug was not replaced throughout the study. At the same time, patients with mild and moderate clinical course of SSG for 30 days received Delfanto® at a dosage of 60 mg, and with severe course — 120 mg per day.Results. All patients on the background of complex therapy showed a significant decrease in the severity of subjective manifestations of the dry eye syndrome, an increase in the of the tear film stability and indicators of tear production. At the same time, the dynamics of changes in these parameters of the course of the xerotic process increased as the therapy continued, reaching a maximum by the 30th day. The maximum effect of Delfanto® in the complex therapy of patients with dry eye syndrome was observed in patients with chronic meibomian blepharitis. Moreover, patients with a mild clinical course of cornealconjunctival xerosis were the most susceptible to the therapy.Conclusion. The effectiveness of the complex therapy for patients with dry eye syndrome can be significantly increased by prescribing Delfanto® in a daily dose of 60 mg for mild and moderate xerosis and 120 mg — for severe disease. Delfante® can be recommended for widespread clinical use in complex treatment of patients with various clinical and pathogenetic forms of dry eye syndrome.

The artificial tears on the basis hyaluronic acid is primary importance today in dry eye syndrome (DES) treatment. In recent years, they have been supplemented Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) differing concentrations of sodium hyaluronate and viscosity. The study is devoted to assessing the effectiveness of these drugs in the treatment of patients with dry eye syndrome (DES) of various etiology and severities.There were 73 volunteers with DES of various etiology: 21 — Sjogren’s syndrome, 24 — meibomian blepharitis, and 28 — perimenopause in the study. All patients were divided into 2 groups: 36 patients of the first group received instillations into conjunctival cavity of the Optinol® Express Moisture (0.21 %) and 37 patients of the second group — Optinol® Deep moistening (0.4 %).Starting from the first days of therapy, all patients had a decrease in the severity of subjective signs of DES, estimated by the value of the ocular surface disease index (OSDI). At the same time, tendency to stop of the degenerative changes in the epithelium of the ocular surface was established. It is characterized by a decrease in the degree of staining. The increasement of the tear film stability and an index of the tear meniscus was found in all patients. The dynamics of the controlled parameters increased, as the instillation of the drugs took place and by the 30th day of therapy. There were significant differences from the baseline values. At the same time, the Optinol® Express Moisture (0.21 %) was more effective (mainly in terms of subjective discomfort and the severity of degenerative changes in the epithelium of the ocular surface) in patients with mild and extremely severe form of the xerosis process.The drug Optinol® Deep Moisture (0.4 %) was more effective in patients with xerosis of moderate severity and severe by the same parameters. In the course of research, we have not observed any side effects of both drugs. It allows us to recommend the drugs Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) to widespread clinical use in treating patients with DES of various etiology.

The problems of resistance to modern antibiotics and fluoroquinolones naturally stimulate interest in the development of eye dosage forms based on antiseptics. Today, their list has successfully supplemented the domestic drug Okomistin eye, ear, nasal drops (0.01 % — benzyldimethyl-myristoylamino-propylammonium), the manufacturer of Infamed-K. Numerous clinical studies performed, however, on adult patients, indicate a high therapeutic efficacy of the drug Okomistin®. However, with respect to children, the efficacy of Okomistin® remains unclear, although the drug has been approved for use by children from birth today. Objective. To evaluate the effectiveness of the Okomistin® in the treatment of children with bilateral bacterial conjunctivitis. Patients and Methods. Material research consisted of 30 children aged 3–16 years with bilateral acute bacterial conjunctivitis. 15 of them (26 eyes) received six-time instillations of the Okomistin® and 15 (24) — 0.05 % — Рicloxidin. All were subjected to traditional clinical examination and examination of the microflora of the conjunctival cavity with the determination of its sensitivity to antibiotics using the disk method. Results. In the spectrum of microflora found in the examined children, Staphylococcus Аureus dominated (14 eyes (53.8 %) — in the group of patients receiving Okomistin® and 13 (54.2 %) — Picloxidin), and Еpidermal Staphylococcus — 12 (46, 2 %) and 12 (50.0 %), respectively. Against the background of six-fold instillations of the compared drugs, a pronounced positive dynamics was established in relation to the relief of objective and subjective clinical symptoms of bacterial conjunctivitis already in the first week of treatment. At the same time, on the 7th day of therapy, in both groups of children, a significant decrease in the frequency of detection of microflora in the conjunctival cavity was noted, and on the 10th day, all the examined people underwent the contents of the conjunctival cavity to be sterile. Conclusion. The clinical efficacy of the Okomistin®, in combination with the absence of side effects of the drug and the affordable cost, allows recommending it for widespread practical use in pediatric and adult ophthalmology in the treatment of eye diseases of a bacterial nature. It seems promising to study the effectiveness of the drug in order to reorganize the conjunctival cavity in infants with dacryocystitis.

The importance of vernal keratoconjunctivitis (vernal conjunctivitis, or vernal catarrh) is not so much due to its level of prevalence (today its occurrence amounts to 1.25-11.29 per 10 000 population of European countries), but rather to the severity of its clinical course. Especially significant is its tarsal form, which is complicated in 3-11 % of vernal keratoconjunctivitis patients by the development of corneal ulcers. Such patients are normally treated by antiallergic agents, which offer both antihistamine and mast cell-stabilizing action. Primarily, the medicines used are 0.1 % olopatadine and 0.025 % ketotifen, which can also reduce the activation of eosinophils and the production of pro-inflammatory cytokines. The therapy of resistant forms of the disease is successfully supplemented with instillations and / or ointment forms of glucocorticoids, cyclosporine-A, tacrolimus and mitomycin-C. Giant papillae that cause gravitational ptosis or are combined with the torpid current of the disease require surgical treatment. They are excised (or cryodestructed) with intraoperative treatment of the tarsal conjunctiva with 0.02 % mitomycin-C and subsequent instillations of cyclosporine-A. There is a need to further develop and introduce into clinical practice new pathogenetically oriented medicinal preparations which provide both relief of clinical symptoms of the disease and the prevention of its relapses. For citations: Brzheskiy V.V. On the prevalence of vernal keratoconjunctivitis and current possibilities of treatment. Russian ophthalmological journal. 2017; 10 (4): 74-81. doi: 10.21516/2072-0076-2017-10-4-74-81 (in Russian).

In recent years, dry eye syndrome has attracted an increasing attention from ophthalmologists all over the world. This is largely due to the prevalence of the disease: the average number of people suffering from the disease is 14--15% of the adult population of the developed countries and up to 45% of patients first visiting ophthalmologist [2]. The other reason is severity of the clinical course and outcomes of some clinical types of the dry eye syndrome.

Purpose: Investigation of microflora of conjunctiva and its resistance to antibacterial drugs in healthy children and patients with various inflammatory eye diseases.Methods: We examined 402 children (421 eyes) in the age from 1 month till 17 years: 62 healthy children (70 eyes) and 340 pa- tients with different inflammatory diseases of anterior segment of eye (351 eyes). the smear was done in all children for plating and definition of sensitivity of microflora to antibacterial drugs by method of diffusion to agar.Results: the plating was positive even in 72.9% of healthy children who entered the hospital for the planned surgery. Most often we revealed Staphylococcus epidermidis (44.3%), Staphylococcus aureus (12.8%), Streptococcus faecalis (5.7%) and Enterobacter (2.9%). In children with inflammatory diseases Staphylococcus epidermidis and Staphylococcus aureus (62.6%) were found fre- quently. the analysis of data showed high level of resistance of all microflora to aminoglycosides (neomycin 37.8% and tobramycin 32.7%) and chloramphenicol — 37.1%. the lowest resistance of all microflora was registered to levofloxacin (11.1%) and ciprofloxacin (10.5%). In gram-negative microflora we revealed the maximal sensitivity to ciprofloxacin, in gram-positive — to levofloxacin.We detected the maximal resistance of microflora to ampicillin (66.1%), and minimal — to cephalosporines (4.5%) among the antibiotics of systemic application.Conclusion: the findings allow us to recommend drops containing levofloxacin (Signicef) for clinical practice in pediatric ophthalmology.

Recently, the interest of national ophthalmologists to drug therapy of dry eye syndrome has been growing. In proportion to the growing relevance of the issue, there has been an increase in incidence of dry eye syndrome (DES) and expansion in the range of artificial tears which are the basis for therapy of patients with DES [1, 2, 6].