PURPOSE. To determine the age-related increase in lens thickness (LT), decrease in anterior chamber depth (ACD) and anterior chamber angle (ACA) in patients with short axial length (APA) of the eyes.METHODS. The study included 100 patients (200 eyes) with short AL (23 mm or less), with a transparent lens or with initial stage of age-related cataract: 46 men and 54 women, aged 19 to 85 years. The LT and ACD, ACA parameters were assessed using optical coherence tomography.RESULTS. In the total population of patients, LT increased by an average of 32 μm per year. At the same time, ACD and ACA decreased by an average of 14 µm and 0.3° per year, respectively (p<0.001). In men, LT increased by 35 μm per year, while in women it increased by 29 μm per year, the difference was not statistically significant (p=0.071). But the decrease in ACA in men averaged 0.38° per year, while in women it was 0.23° per year, this difference was statistically significant (p=0.003). In addition, the rate of decrease in the ACD in men and women also differed statistically significantly: 18 µm versus 11 µm per year (p=0.018).CONCLUSION. 1. According to our data, the annual increase in LT in eyes with short AL averages 32 μm, the decrease in ACD and ACA is on average 14 μm and 0.3° per year, respectively.2. We did not find a statistically significant gender difference in the rate of annual increase in LT, although the rate of decrease in ACA and ACD in men turned out to be statistically significantly higher.3. The obtained data on the annual changes in such morphometric parameters as LT, ACA and ACD in eyes with short AL are key in the formation of primary angle-closure glaucoma (PACG). It may allow a more precise prediction of the timeline of an increased risk of PACG in each particular case.

Eosinophilic esophagitis and asthma are often found as part of comorbid pathology in children and adults, along with other manifestations of atopy. The two diseases share similar pathophysiology due to T-helper type 2 responses, common treatment approaches such as the use of glucocorticosteroids and targeted anti-cytokine biologic therapy. Patients with eosinophilic esophagitis, as with asthma, often have elevated serum markers of atopy, including IgE levels, peripheral eosinophil counts, and T-helper type 2-associated cytokines. A review of the literature shows that the true incidence of eosinophilic esophagitis remains poorly understood due to the difficulty of diagnosing this pathology, which has a mask of gastroesophageal reflux disease. Gastroesophageal reflux disease has been shown to influence asthma through microaspiration, airway hyperresponsiveness, and increased vagal tone. Understanding the relationship between gastroesophageal reflux and eosinophilic esophagitis is also being actively explored. Many works show the high efficacy of PPIs in the initial treatment of eosinophilic esophagitis and gastroesophageal reflux disease. The development of new clinical diagnostic criteria for eosinophilic esophagitis will improve the differential diagnosis of this disease and the improvement of therapeutic strategies for managing this pathology, especially in combination with asthma.

Introduction. Bronchial asthma (BA) is a multifactorial disease, but its pathogenesis in children is based on atopic inflammation, which is what modern therapies are aimed at combating; less attention is paid to factors of nonspecific inflammation, but they also affect the controllability of the pathological process. The regulation of any inflammation is carried out primarily by cytokines, therefore this work is devoted to the study of polymorphisms of genes for cytokines of nonspecific inflammation.Aim. To explore the association between cytokine gene polymorphisms and clinical immunological features of uncontrolled asthma.Materials and methods. We examined 167 children with asthma, who were divided into groups with and without complete disease control, according to the standard of clinical guidelines for asthma. Additionally, mononucleotide substitutions in the cytokine genes were determined: IL4-C589T (rs2243250), IL6-C174G (rs1800795), IL10-G1082A (rs1800896), IlL10-C592A (rs1800872), IL10- C819T (rs1800871), IL12B-A118 8C (rs3212227) , TNFα- G308A (rs1800629), serum cytokine levels: IL4, 5, 6, 7, 8, 9, 10, 18 and TNFα; standard immunogram indicators: subpopulations of lymphocytes, neutrophil phagocytosis and levels of Ig A, M, G, E.Results and discussion. It was determined that each of the clinically significant mononucleotide substitutions forms a unique cytokine and immune profile that is phenotypically realized in the clinical manifestations of the disease. It has been proven that mononucleotide substitutions IL10-C592A, TNFα- G308A contribute to better control with a tendency to milder asthma; children with the IL6-C174G polymorphism experience more severe disease with a tendency toward decreased control. In addition, mononucleotide substitutions in the genes of signaling molecules of the immune system modify atopic inflammation, weakening (IL10-C592A, TNFα- G308A) or enhancing (IL6-C174G) it, which leads to a change (decrease or increase) in the dose of TGCS, respectively.Conclusion. Thus, determination of IL6-C174G (rs1800795), IL10-C592A (rs1800872), TNFα- G308A (rs1800629) polymorphisms in children with ВА helps to identify a risk group for severe and uncontrolled disease, as well as to personalize therapy.

Purpose. Demonstration of non-standard clinical case of removing large fragment of metal wire from the eye. Patient and methods. Patient, 37 years old, with penetrating right eye injury with intraocular foreign body (IOFB) introduction — a fragment of metal wire. After unsuccessful attempt to remove IOFB during primary repair of eye injuries lacerations by ophthalmologist of the surgical department of the district hospital, he was sent to the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution. On admission: VIS OD — 0.01 uncorrected, intraocular pressure (IOP) — 16 mm Hg (noncontact tonometer TOMEY, Japan). OD — metal IOFB protrudes by 1.0 mm from the corneoscleral laceration in projection of corneal limbus at the 13 o’clock position, postoperative aphakia; according to B-scan ultrasonic data: metallic foreign body of linear shape, 14.3 mm long, about 1.5 mm thick. There is hemorrhage in the vitreous cavity. Results. Initially, conditions for visualization of the vitreous cavity were created by performing 25G vitrectomy. The course of wire location was specified: under the choroid and retina, going out through the sclera in the equatorial region. After conjunctival tweezers expanded wound edges, the embedded fragment of wire was delicately remove: 25 mm in length and 2 mm in diameter. A single retinal break was delimited by cryotherapy and laser photocoagulation. On the 2nd day: VIS OD — 0.3 with diaphragm, uncorrected; IOP — 13 mm Hg. After 3 months: VIS OD — 0.01 sph + 13.0 D = 0.7, IOP — 14 mm Hg. Silicone removal was combined with intraocular lens implantation model RSP-3 (+23D). The next day: VIS OD — 0.3 with diaphragm, 0.5 cyl — 6.0 D ax 170 = 0.5; IOP — 16 mm Hg. Conclusion. Use of 25G vitrectomy for removal IOFB localized between the inner membranes of the eye created optimal conditions for visualizing depth of its penetration, which minimized traumatic impact and avoided severe intra- and postoperative complications.

Purpose. To study state of ocular hemodynamics in pregnant women with disorders of carbohydrate metabolism using color Doppler imaging. Patients and methods. 147 pregnant women were examined: 40 of them had type 1 diabetes mellitus (DM), 87 had gestational diabetes (GD); in 20 — pregnancy proceeded physiologically. Examination of pregnant women with DM was carried out in each trimester and 3 months after delivery, pregnant women with GD and control groups — once in the third trimester. The parameters of hemodynamics in the central retinal artery (CRA) and in the short posterior ciliary arteries (SPCAs) were studied using color Doppler imaging. Results. It was found that the peak systolic velocity (PSV) in the CRA was significantly lower in the GD and DM groups, while PSV in the SPCAs and end-diastolic velocity (EDV) in the CRA were higher in the control group compared to the GD. In SPCAs, the resistive index (RI) was the highest in the DM group, and the lowest in the GD group. Conclusion. In patients with GD in the third trimester of pregnancy, there is a statistically significant decrease in PSV and EDV in the CRA and SPCAs, combined with a decrease in RI in SPCAs, compared with patients with a physiological course of pregnancy. In patients with diabetic retinopathy (DR) in the third trimester of pregnancy, PSV and EDV in the CRA and SPCAs were significantly lower, and the pulsatility index (PI) and RI were significantly higher compared to pregnant women with DM without DR. In pregnant women with DR during gestation, there was a decrease in PSV and EDV against the background of an increase in RI and PI in the CRA and in the SPCAs. In pregnant women with DM and absence of DR during gestation, there was an increase in PSV, EDV and PI in the CRA and SPCAs from the first to the third trimesters. The revealed features of the state of hemodynamics in the CRA and SPCAs in pregnant women with DM with presence or absence of DR can become the basis for creating criteria for manifestation and progression of DR.

The article considers historical interaction between the Soviet Russia and the Weimar Republic related to prevention of caries in children in 1920s and the role of P. G. Dauge in it. The methodology of German Professor A. Kantorovich with minor alterations was adopted to be applied in organization of dental care of schoolchildren in the RSFSR. In the Soviet Russia, the practical implementation of planned oral cavity sanation in children started on a national scale only in second half of the 1920s. It was caused by skeptical attitude of dentists to methodology of "planned sanation" in conditions of the Soviet Russia.

The review describes the combination of hypertension (HTN) and smoking in the same person. The prevalence of this combination in the Russian population is high due to the widespread prevalence of both HTN and smoking. There are following unidirectional negative impact of both factors on vascular system: endothelium, microcirculation, large vessel stiffness, contributes to higher blood pressure among such patients and leads to early target organ damage, increased cardiovascular and death risk. Smoking cessation is the main effective measure of primary and secondary prevention among smoking patients with HTN. The review provides links to well-known articles and the results of studies showing the benefits of smoking cessation. However, it is not easy for smoking patients with hypertension to quit smoking: on the one hand, nicotine addiction, similar to drugs, through central nervous system exposure, makes the habit stable, while on the other hand, the low motivation of such patients due to young age and the absence of current smoking consequences, which complicates working with such patients. Knowledge of algorithms for working with smoking patients and methods of non-drug support can help practitioners supporting such patients at the stage of smoking cessation.

Rituximab is a chimeric (mouse and human) monoclonal antibody against B-lymphocytes (CD20). This drug is widely used in rheumatology in the treatment of rheumatoid arthritis, Sjogren’s syndrome, some systemic connective tissue diseases and vasculitis, as well as in hematology in lymphoproliferative diseases. Administration of rituximab leads to depletion of B-lymphocytes through various mechanisms, including antibody-dependent and complementdependent cytotoxic effects, as well as the regulation of apoptosis. Considering the mechanism of autoimmune damage in Graves’ disease, an autoimmune thyroid disease accompanied by thyrotoxicosis and endocrine ophthalmopathy (an autoimmune lesion of the accessory apparatus of the eye), the use of rituximab may be effective in these diseases. The review considers the currently available results of studies on the use of various doses of rituximab in these diseases.