Ophthalmological Problems Research Articles

Occlusive lesions of retinal vessels: etiological and patogenetic factors

Background. Vascular pathology of the organ of vision is one of the most urgent problems of ophthalmology, as it is the main cause of vision loss and vision loss. Retinal vein occlusion ranks second after diabetic retinopathy in the world among vascular causes of vision loss. In a significant risk group for the occurrence of occlusions of the retinal vessels are patients with cardiovascular diseases. Today, treatment of patients with coronary heart disease and patho­logy of heart valves is impossible without surgical interventions, most of which require the use of artificial circulation (AC). During the operation of the AC due to prolonged hypothermia, hemodilution, prolonged hypotension, anemia, development of ophthalmologic complications in the early postoperative period is possible. The purpose of the study was to investigate etiological and pathogenetic factors of occlusive lesions of retinal vessels. Mate­rials and methods. The search for sources of Ukrainian and foreign literature for the ana­lytical review was conducted keywords using the open medical scientific database PubMed (USA). At the first stage, 211 sources were selected, of which 66 were selected for this article. Results. Occlusion of the central retinal vein (CVO) deve­lops in 214 people per 100,000 population, mainly in people over 65 years of age. The frequency of branh retinal vein occlusions (BRVO) is 67.2%, of which 82.4% is a occlusion of the superior temporal branch. The main risk factors of CVO are age, hypertension, diabetes, atherosclerosis, glaucoma, coronary heart disease. A small number of sources are found in the literature regarding complications from the organ of vision in patients after cardiac surgery with AC such us thromboembolism of retinal vessels, optic ischemic optic neuropathy, retinal ischemia, optic nerve atrophy, retinal detachment, proliferative vitreoretinopathy. The authors' research showed a multiple increase in blood markers of endothelial dysfunction, including vascular endothelial cadherin (VE-cadherin, VE-C) after surgery. Conclusions. Diseases of the organ of vision due to general or local blood circulation disorders account for 10 to 28%, 2.6% of which lead to blindness. There is a relationship between occlusive lesions of retinal veins and cardiovascular diseases. The main reasons for the development of retinal vein occlusion after cardiac surgery with coronary artery disease are acute inflammation occurring during and immediately after surgery and endothelial dysfunction.

A recent algorithm for management of orbital floor fractures with the application of a novel minimally invasive endoscopic surgery

Orbital floor (OF) fractures present a dilemma, with controversies surrounding surgical indication, approach, and ideal material for reconstruction. Our study was conducted on cases of OF fracture admitted to a tertiary referral centre. Cases of OF associated with zygomaticomaxillary complex (ZMC) fracture were managed as follows: those with ophthalmological problems were subjected to endoscopically assisted transorbital reconstruction of the floor; cases without ophthalmological problems were subjected to reduction and fixation of the ZMC fracture only. The recently developed endoscopic endonasal transmaxillary approach was used to manage cases with pure OF fracture, while the same approach with added endoscopic transethmoidal reconstruction of the medial orbital wall (MOW) was applied to cases with associated MOW fracture. Outcome measurements were the correction of diplopia and enophthalmos, along with the restoration of normal globe function. The study included 80 patients, who were divided into four groups according to the proposed algorithm. OF reconstruction was performed in 32 cases with either septal cartilage (n = 4), titanium plate (n = 11), or porous polyethylene mesh (n = 17). Our study presents the novel role of minimally invasive endoscopic surgery in the management of OF fracture, together with a recently developed management plan that could maximize positive outcomes and decrease morbidity.

Deep phenotyping of 11 individuals with pathogenic variants in RNU4-2 reveals a clinically recognizable syndrome

PurposeDespite ever-increasing knowledge of the genetic etiologies of neurodevelopmental disorders, approximately half remain undiagnosed after exome or genome sequencing. Here, we provide a deep clinical characterization of 11 previously unreported patients with a recently described neurodevelopmental disorder (NDD) due to pathogenic variants in RNU4-2. MethodsThe 11 patients were identified in a pool of 70 patients selected for targeted RNU4-2 sequencing on the basis of their clinical phenotypes from a cohort of 1032 individuals with a NDD and without a prior genetic diagnosis. ResultsThe 11 patients were aged between 13 months and 36 years. All patients showed moderate to severe developmental delay and/or intellectual disability. Height and weight were below 10th percentile and most showed microcephaly. In almost 50% of the patients, intrauterine growth retardation was detected. All patients showed a distinctive pattern of dysmorphic features, including hooded upper eyelid and epicanthus, full cheeks, tented philtrum, mouth constantly slightly open with an everted lower lip vermilion, high palate, and profuse drooling. Of 11 patients, 64% also presented with ophthalmological problems (mainly strabismus, nystagmus, and refraction errors) and 64% had musculoskeletal features (joint hypermobility, mild scoliosis, and easy fractures). ConclusionThis work provides an improved characterization of the phenotypic spectrum of RNU4-2 syndrome across different age groups and demonstrates that thorough clinical assessment of patients with an NDD can be enhanced significantly for this novel syndrome.

A review of the Carotid-cavernous fistula

The carotid-carvenous fistula is a specific type of arteriovenous connection at the cavernous sinus which causes series of serious ophthalmologic problems. In this article is described the symptoms, the treatment ( open or endovascular) and the etiology of CCF. Also is mentioned to the types of CCF according with the blood flow and to the Barrow anatomical classification.

Case 333.

A 61-year-old male patient without prior history of ophthalmologic problems presented with pain and redness in the left eye associated with slowly progressive proptosis over the previous 6 months. The patient also had diplopia in rightward and downward gaze. There was no vision loss. Mild fullness was seen in the periorbital tissues without any redness or fluctuance and with no purulent discharge from the left eye. The patient was otherwise healthy, with a 6-year history of diabetes mellitus and an 8-year history of hypertension managed well with medication. There was no history of trauma to the head or face. At clinical examination, conjunctival edema and redness with proptosis were noted. The cornea was clear. Evaluation of eye movements revealed restricted motion of the left eye in medial gaze and downward gaze. Ophthalmoscopic evaluation did not show any substantial abnormality. The retina and retinal vascularity were unremarkable. The right eye was unremarkable. Uncorrected visual acuity was 20/30 in the right eye and 20/40 in the left eye. Corrected visual acuity was 20/20 in both eyes. Complete blood cell count, as well as liver and kidney function test results, were within normal limits. The erythrocyte sedimentation rate and C-reactive protein level were normal. Thyroid function test results were normal. The patient subsequently underwent CT of the orbits without and with contrast enhancement (Fig 1) followed by further evaluation with MRI of the orbits without and with contrast enhancement (Figs 2-4).

Suspicious eyes - Elvis's glaucoma battle.

Elvis Presley (1935-1977) is an iconic figure in modern pop culture. Although many of his medical conditions have been the subject of extensive speculation, less is known about his ophthalmological problems, including steroid-induced glaucoma caused by a life-long use of steroids, both prescribed and self-administered, and secondary angle closure glaucoma most likely due to anterior uveitis. Further, he had an episode of acute angle closure glaucoma in 1971 that was treated with a subconjunctival injection of a mydriatic agent or, less likely, a paracentesis combined with an iridotomy. David Meyer, MD, was Presley's main ophthalmologist from 1971 until the latter's death in 1977.

Blepharitis and tear duct problems

Ophthalmological problems make up approximately 2% of all consultations in primary care. The majority of problems are minor, encompassing ailments such as conjunctivitis, foreign bodies, blepharitis, subconjunctival hemorrhage, corneal abrasions, chalazions, and ectropions. However, more complex presentations, including ptosis and cataracts require accurate diagnosis, and may need referral to secondary care. General practitioners and members of the broader practice team, including advanced nurse practitioners and GP registrars, are likely to encounter such cases at least once every week. This article considers blepharitis and associated tear duct problems, providing a review of the simple and more complex presentations and their management. It will cover assessment in primary care, triggers, pathogenesis, epidemiology, typical presentations, clinical features, differential diagnoses, prevention, management strategies, and when referral to secondary care is necessary.

Valuing Outpatients' Perspective on Primary Health Care Services in Greece: A Cross-Sectional Survey on Satisfaction and Personal-Centered Care.

The aims of the study were to identify and analyze the determinants associated with outpatient satisfaction in Greek primary care. This is because there is a general consensus that primary care is the linchpin of effective person-centered care delivery. A cross-sectional survey was conducted with 1012 patients' exit interviews; sociodemographic variables were included in the questionnaire to obtain data on the satisfaction of primary care users with 20 public primary healthcare centers in Athens between June 2019 and April 2021. Statistical analysis was applied to 55 items and eight dimensions of patient satisfaction, namely, arrival and admission, waiting before the appointment, cleanliness of toilets, medical examination and behavior of physician, behavior of nursing staff, laboratories, departure, and contribution of the PHCs. Descriptive analyses and multiple linear regression were used to analyze the factors influencing patient satisfaction through coefficients (β) with 95% confidence intervals and associated tests of statistical significance. Τwo-thirds (74.21%) of this survey's participants ranged from 45 to 74 years of age. More than half of the participants were women (62.15%). The most common reasons for visits were pathological (26.48%), followed by cardiological conditions (9.78%), orthopedics (9.49%), gynecologic conditions (8.70%), and ophthalmologic problems (7.31%). In the center of satisfaction with primary care was the medical care and the behavior of the physician (β = 0.427; p < 0.01), followed by the time during appointment (β = 0.390; p < 0.01). Dimensions like "accessibility and availability, 2.19/5"; "waiting times, 2.89/5"; "infrastructure of facilities (2.04/5) and cleanliness of them, (2/5)"; "laboratories, 2.99/5" and "bureaucracy in the departure, 2.29/5" were crucial for the trust and satisfaction of patients. Overall satisfaction was rated at a moderate level (2.62 ± 0.18) while person-centered care was rated as weak (2.49 ± 0.28). Greece is recommended to increase the sensitivity of the use of the primary health care system by patients as a first contact, continuous, comprehensive, and effective patient- and family-focused care.

Special features of postoperative long-term follow-up patients with retinopathy of prematurity

Background: Retinopathy of prematurity (ROP), leading to a high percentage of visual disability, continues to be one of the most complex and unresolved problems of pediatric ophthalmology. Some patients, despite successful surgical treatment and regression of ROP, lose their vision by the age of 25–35 years from the long-term consequences of ROP. That is why patients after surgical treatment of ROP, including those with peripheral chorioretinal dystrophy, need lifelong clinical follow-up in order to on time diagnose reactive conditions in the long-term postoperative period, leading to a significant loss of visual function. Methods: This paper presents a special case of a patient with stage 4 ROP and her long-term clinical and functional outcome. Conclusions: As a result of regular dynamic monitoring of the patient, using modern highly informative research methods, we promptly detected the formation of an exudative component of the macular area, which made it possible to prevent retinal detachment and loss of vision. Strengths of this study: This study presented a clinical case of a patient with ROP and long-term patient follow-up. This shows the importance of long-term monitoring of patients after treatment and the importance of combining treatment methods.

Microstructural changes in the retina in children with retinopathy of prematurity according to optical coherence tomography. Literature review

Retinopathy of prematurity (ROP) is a crucial problem in modern ophthalmology. ROP is a vasoproliferative disease of the eyes in premature infants. Approximately 50,000 children worldwide have become blind because of ROP. The determining indicator in the development of visual acuity is the morphofunctional state of the macula, structural changes of which can lead to disturbances in its functions and, consequently, decreased vision. The present review analyzed available OCT (optical coherence tomography) data on the morphometric and structural state of the retina in children with ROP. Morphometric features of the macular zone in children in the scar period of ROP can be presented by an increase in retinal thickness in the center of the fovea and changes in the profile of the macula by smoothness or absence of foveal depression. These are more pronounced in children after laser coagulation of the retina in the active phase of ROP and in very premature babies. In some cases with increased retinal thickness in the center of the fovea, the presence of internal layers and an increase in the thickness of the outer nuclear layer are noted. Structural features of the macula with favorable outcomes of RP can be expressed by traction displacement of the foveola, photoreceptor layer thinning and pigment epithelium unevenness, intra and epiretinal fibrosis, choriocapillaris layer atrophy, discontinuity of the connection of the outer and internal segments of the photoreceptors and the pigment epithelium–choriocapillaris complex, and central retinoschisis. Furthermore, this review presents mixed results from studies on the impact of structural changes in the macula in cicatricial ROP on visual function.

The use of two or more courses of low-dose systemic dexamethasone to extubate ventilator-dependent preterm neonates may be associated with a higher prevalence of cerebral palsy at two years of corrected age

BackgroundOur objective was to determine whether the use of two or more courses of low-dose systemic dexamethasone for extubation of ventilator-dependent preterm infants after the first week of life, as proposed in the DART study, is associated with greater neurodevelopmental harm at two years of corrected age, compared to a single course. MethodsRetrospective review at seven level III neonatal intensive care units. Preterm infants who underwent only one course of systemic dexamethasone for extubation were grouped into DART-1; those who underwent two or more courses were grouped into DART-2. Data and outcomes of infants in DART-2 were compared with those in DART-1. Results150 preterm infants were studied: 104 in DART-1 and 46 in DART-2. Patients in DART-2 had a lower gestational age (25 vs. 26 weeks, p = 0.031) and greater morbidity. The average dexamethasone cumulative dose for patients in DART-1 was 0.819 mg/kg, vs. 1.697 mg/kg for patients in DART-2. A total of 14 patients died. The neuromotor and neurosensory assessments at two years of corrected age revealed in the DART-2 survivors, after the multivariate analysis, a higher prevalence of cerebral palsy with functional motor class 2 (OR = 6.837; 95%CI: 1.054–44.337; p = 0.044) and ophthalmological problems requiring the use of glasses (OR = 4.157; 95%CI: 1.026–16.837; p = 0.046). ConclusionsIn this cohort, the use of more than one course of systemic dexamethasone in low doses for extubation of ventilator-dependent premature infants after the first week of life was associated, at two years of corrected age, with a higher prevalence of cerebral palsy with functional motor class 2 and ophthalmological problems requiring the use of glasses.

Simplified Convolutional Neural Network Model for Automatic Classification of Retinal Diseases from Optical Coherence Tomography Images

Optical coherence tomography (OCT) allows for direct and immediate imaging of the morphology of retinal tissue. It has become a crucial imaging modality for diagnosing eye problems in ophthalmology. One of the most significant morphological characteristics of the retina is the structure of the retinal layers, which provides important evidence for diagnostic purposes and is related to a variety of retinal diseases. In this paper, a convolutional neural network (CNN) model is proposed that can identify the difference between a normal retina and three common macular diseases: Diabetic macular edema (DME), Drusen, and Choroidal neovascularization (CNV). This proposed model was trained and tested on an open source dataset of OCT images also with professional disease classifications such as DME, CNV, Drusen, and Normal. The suggested model has achieved 98.3% overall classification accuracy, with only 7 wrong classifications out of 368 test samples. The suggested model significantly outperforms other models that made use of the identical dataset. The final results show that the suggested model is particularly adapted to the detection of retinal disorders in ophthalmology centers.

Prevalence of myopia in schoolchildren of a highly urbanized city in Eastern Siberia

Myopia is one of the most urgent problems of modern ophthalmology. Statistics show that the number of children and adolescents suffering from myopia is steadily increasing worldwide. But it also noted that in different regions of the Russian Federation, the proportion of children who are diagnosed with myopia may differ markedly. Purpose: to determine the prevalence and structure of myopia in schoolchildren of the city of Krasnoyarsk, depending on age and gender. Materials and methods. A survey of 3005 students of secondary schools in the city of Krasnoyarsk aged from 6 to 18 years, including 1,421 schoolboys and 1,584 schoolgirls, was conducted. Refraction was determined after cycloplegia using the autorefractometry method. Results. The predominant type of refraction in primary school students of both fi elds is emmetropia, myopia is in second place and other refractive errors are in third place. The prevalence of myopia in schoolchildren increases as they grow up. At the same time, in the schools of the city of Krasnoyarsk, already in the primary grades in the group of subjects of both sexes, the proportion of students with myopia was 17.9 %, in the middle – 36.8 %, and by the high classes it reached 49.7 %. When considering the data obtained, depending on gender, approximately the same proportions of myopia were found in primary grades in both schoolgirls (19.2 %) and schoolchildren (16.7 %), in middle grades, a statistically significant predominance of myopic refraction in girls, compared with boys (42.8 and 29.5 %, respectively, p &lt; 0.05). In high school, the proportion of myopia increases both in girls to 52.1 % and in boys to 47.2 %. The proportion of subjects with emmetropic refraction decreases as individuals of both sexes grow up. The percentage of other refractive errors remains without significant gender-age changes. Low myopia was the most common in all groups, but its percentage significantly decreased as they moved to higher grades, simultaneously with an increase in the proportion of moderate and high myopia. Conclusions. There is an increase in the prevalence of myopia in schoolchildren as they move to higher grades. A threefold increase in the proportion of myopia in high school compared with primary school was revealed. It is necessary to further study the prevalence of myopia in all Russian regions and develop preventive programs to control myopia in children.

Частота встречаемости воспалительных заболеваний придаточного аппарата глаза среди детей и подростков больных туберкулезом

Pathology of the accessory apparatus of the eye is widespread among children and adolescents and remains one of the most pressing problems of pediatric ophthalmology. This article provides information on the occurrence of inflammatory diseases of the accessory apparatus of the eye in children and adolescents with tuberculosis. Studies have shown that the most common pathology of the accessory apparatus of the eye in children and adolescents with tuberculosis was blepharitis and chronic conjunctivitis, which amounted to 45.9 ± 1.2 %. The detection rate of blepharitis was 25.7 ± 1.1 %, the incidence of chronic conjunctivitis among children and adolescents with tuberculosis was 20.0 ± 1.0 %. Inflammatory diseases of the accessory apparatus of the eye can cause many complications and reduce the quality of life in children and adolescents with tuberculosis. Therefore, it is necessary to carry out timely diagnosis, treatment and prevention of complications of these diseases. Keywords: blepharitis, chronic conjunctivitis, incidence, children, adolescents, tuberculosis

HUMAN RESOURCES DEVELOPMENT IN CHILDREN EYE HEALTH SERVICES IN SOUTH SULAWESI

Introduction: Children eye health are one of the most common problems in ophthalmology that are getting attention globally and nationally especially in South Sulawesi. To optimize its services quality and quantity of human resources are required. This study aims to report the human resources development in children eye health services in South Sulawesi.&#x0D; Methods: Surveys were carried out in several districts to assess the availability of human resources in children eye health services. Creating collaborations with several institutes such as Faculty of Medicine, Hasanuddin University and related professional organizations. Conducting several trainings in provinces, districts, subdistricts, village, and urban village.&#x0D; Results: Preparation and dissemination of materials and media on prevention of blindness in children, improvement of human resources in the form of District Trainer training in 24 districts that recruited 98 people who were ready to become trainers. For 2 years conducting tiered training at 24 districts, they produced human resources of 1,395 officers at the Puskesmas, 11,145 posyandu cadres, and 3,826 teachers. The results of this built system revealed that 3,248 paediatric patients were screened with vision problems, 3,528 toddlers in Integrated Health Centre were screened and referred to Health Centre as many as 426 toddlers, and at the School Health Unit it was recorded that 173,778 children were screened and there were 28,845 (17%) children who had visual disturbances.&#x0D; Conclusion: Development of human resources in children eye health in Indonesia was not only the responsibility of the government and the health sector but also need cross-sectoral roles.

Ophthalmologic findings in Cornelia de Lange syndrome

Introduction : Cornelia de Lange syndrome (CdLS) is a rare disease characterized by multisystem abnormalities, including various ophthalmologic problems. The purpose is to report this kind of rare case and highlight the role of ophthalmologist in visual development optimalization.&#x0D; Case Illustration : A 2-year-old boy with CdLS showing bilateral microcornea, cataracts with “dot opacities,” and chin lifts induced by ptosis. We also examined brow hypertrichosis, synophrys, and long arcuate eyelashes. High myopia and high astigmatism was found in the patient with spherical equivalent of 9.8 D. He was born with low birth weight, microcephaly, anteverted nostrils, depressed nasal bridge, thin upper lip, micrognathia, low posterior hairline, short neck, and syndactili. He also showed psychological lag and developmental impairment. Glasses was then prescribed to prevent amblyopia.&#x0D; Discussion : Individuals with CdLS may have multiple treatable ocular conditions. We recommend that patients have an initial ophthalmic examination after diagnosis of CdLS is first made, in order to establish a baseline and to assess for the presence of abnormalities that would benefit from early intervention. Examination under anesthesia may be required in some patients to adequately assess for any abnormalities, and to obtain a good refraction as well as an inspection of the retinal periphery in children with long axial length. Early intervention may greatly improve function and prevent vision loss due to amblyopia.&#x0D; Conclusion : Initial ophthalmic examination followed by routine annual screening is warranted when a diagnosis of CdLS is made, given that ocular anomalies are present in the majority of patients and may impact vision and daily functioning.

Incidence of Dry Eye Syndrome After Cataract Surgery with Phacoemulsification Technique in Padang Eye Center Hospital

Introduction &amp; Objectives : Dry eyes is one of the most common ophthalmological problems. The etiology of dry eyes is usually multifactorial, such as medication, aging, systemic disease, allergy, computer usage, environmental factors, meibomian gland dysfunction and ophthalmic surgery. Cataract is still one of the leading causes of vision impairment globally. No medical treatment is effective to remove cataract. Thus, the only option is cataract removal surgery. The most common technique of cataract surgery in Padang Eye Center Hospital is phacoemulsification. This study aims to assess the incidence of dry eye syndrome after phacoemulsification surgery without complication in patients with no previous history of dry eye syndrome.&#x0D; Methods : This study was conducted using a prospective study. The evaluation uses Ocular Surface Disease Index ( OSDI ) questionnaire and tear break-up time ( TBUT ) test performed preoperatively and three times postoperatively at one week, one month and three months follow-up after surgery.&#x0D; Results : 110 eyes of 96 patients diagnosed with cataracts who had undergone phacoemulsification surgery were enrolled in this study. The mean age of patients is 62.46 ± 6.14 years, and 59,09% were men. After one week of surgery, only 9,09% had results 0-12 on the OSDI scale, and 43,63% represented moderate dry eye disease ( OSDI score 23-32 ) and TBUT test results from 61,82% of patients had dry eyes, which improved gradually after time.&#x0D; Conclusion : The incidence of dry eye syndrome significantly increased after one-week post-surgery. But after one month postoperative, the patients’ condition gradually improved and returned to normal after three months postoperatively.

Unplanned 30-day readmission rate after ophthalmological surgery as a quality-of-care indicator.

The 30-day readmission rate provides a standardised quantitative evaluation of some postoperative complications. It is widely used worldwide in many medical and surgical specialities, and the World Health Organization recommends its use for monitoring healthcare system performance. In ophthalmology, its measurement is biased by the frequent and close planned surgery on one eye and then the other, particularly in the case of cataract surgery. This study measures the 30-day unplanned readmission rate in ophthalmology, globally and by surgery subtype, and describes the causes of readmission. All patients readmitted within 30 days of ophthalmic surgery at Nantes University Hospital between January 2017 and December 2020 were identified in the Medical Information System. An ophthalmologist examined each medical record and collected the following data: the reason for readmission, comorbidities, the pathology treated, surgery type, surgery duration, the surgeon's experience, anaesthesia type, severity and readmission morbidity. For the 8522 ophthalmic surgeries performed in the four-year study period, 282 30-day unplanned readmissions were identified. The overall 30-day unplanned readmission rate was 2.07% for elective surgery, with a high variability depending on the surgery type: 0.95% for phacoemulsification, 4.95% for vitreoretinal surgery (3.42% for non-elective vitreoretinal surgery, 5.44% for retinal detachment surgery), 5.66% for deep lamellar keratoplasty and 11.90% for trabeculectomy. The unplanned 30-day readmission rate for ocular trauma surgery (emergency care) was 11.0%. Seven percent of all unplanned 30-day readmissions were not associated with an ophthalmological problem. This study is the first to report 30-day unplanned readmission in ophthalmology, globally and by surgical subtype, for elective and urgent procedures. This indicator can be used longitudinally to detect an increase in risk or transversely to compare the quality of care between different public or private hospitals.

Grzybicze zapalenia rogówki

Fungal keratitis are important problem in ophthalmology. The most often isolated ethiologic factors are Candida species, Fusarium species and Aspergillus species. Microbiological diagnostics of mycotic infections is long-lasting and has low susceptibility. Effectiveness of antifungal therapy is limited by pathogenes resistance and specific pharmacokinetics of medications used in therapy of eye ball infections.

MATHEMATICAL MODELING OF ASSESSMENT OF THE PROBABILITY OF THE DEVELOPMENT AND PROGRESSING OF DIABETIC MACULAR EDEMA IN PATIENTS WITH TYPE 2 DIABETES

Background. The participation of fractalkine, clusterin and sICAM in the pathogenesis of diabetic complications of the fundus was established. The development of methods of mathematical assessment of the prognosis of the development and course of diabetic macular edema (DME) with the participation of these cytokines is an actual problem of modern ophthalmology and endocrinology.&#x0D; Aim: To develop the prognostic mathematical models for assessing the probability of development and progression of DME in patients with diabetes mellitus (DM) type 2 based on the study of the content of blood serum fractalkine, clusterin and sICAM-1.&#x0D; Material and methods. A single-center selective one-moment open observational study of 82 patients (145 eyes) with DME in type 2 diabetes, divided into 4 groups according to the severity of DME, was conducted. The average age of the patients was 65.25±10.85 years, the average duration of diabetes was 14.0±7.05 years (±SD). The concentration of blood serum fractalkine (Frl), clusterin (Cls) and sICAM-1 was determined by the ELISA, and an instrumental examination of the fundus was performed. Multivariate discriminant analysis was used with the “SPSS 9.0” program. Differences at p&lt;0.05 were considered statistically significant. 3 models with linear combinations of the investigated indicators were developed and corresponding formulas of classification functions (FC) were obtained.&#x0D; Results. Models for assessing the risk of DME development and progression in patients with type 2 DM characterize by the fact that, at the first stage, fix the duration of diabetes mellitus (DD), and measure the concentration of blood serum fractalkine, clusterin, and sICAM-1. Further, with the helpness of ophthalmoscopy, determine the presence and severity of DMN, assigning the code 1 - the presence of concomitant diabetic retinopathy (DRP), the code 2 - the absence of DRP. At the final stage, calculate the classification functions FK1 and FK2 or FK2 and FK3 (depending on the model), compare FK1 with FK2 or FK2 with FK3, and determine which of them is larger according to the appropriate formulas. Moreover, the prognostic decision takes as the choice of the FC that is more important. So, if FK1&gt;FK2, the prognosis is possible the stabilization of the pathological process, and if FK2&gt;FK1 or FK3&gt;FK2, then the prognosis is the probability of progression of the DME.&#x0D; The main model is presented below:&#x0D; FK1DME(0) = -111,278 + 8,57411*Frl + 0,562616*Cls + 0,257994*sICAM -0,139202*DD +7,72433*DRP&#x0D; FK2DME(1) = -101,108 + 8,5887* Frl + 0,544401* Cls + 0,235155*sICAM + +0,0261057*DD + 10,1873*DRP&#x0D; FK3DME(2+3) = -105,68 + 9,06663* Frl + 0,552074* Cls + 0,241348*sICAM -0,102963*DD + 11,8493*DRP&#x0D; Conclusion. The informativeness of mathematical models for assessing the prognostic significance of serum cytokines fractalkine, clusterin and sICAM-1 in the development and progression of DME in patients with type 2 diabetes is 62.5-77.5%, depending on the type of model.