Ekaterina Maslova

Visual impairments are an important medical and social issue affecting the life quality and healthcare economy. Cataracts, glaucoma, myopia and age-related macular degeneration are the leading ophthalmologic conditions. Modifiable behavioral factors and environmental influences play a crucial role in these conditions development. The purpose of this work is to systematically analyze and synthesize current scientific data on how lifestyle affects the prevalence and pathophysiology of ophthalmologic diseases. Modifiable lifestyles correlate with increased risk for major ophthalmologic disorders, such as glaucoma. Physical inactivity, obesity, prolonged use of digital screens, and lack of exposure to natural light all contribute to glaucoma development through vascular and metabolic disturbances. Myopia is also linked to prolonged screen time and a lack of outdoor activity, particularly in children. Unbalanced diets with antioxidant deficiencies accelerate degenerative changes in ocular structures. Smoking increases the risk of cataract and age-related eye disease through oxidative stress. Lifestyle modification is a promising approach to primary prevention of eye disorders. Integrating risk factor information and implementing personalized programs tailored to genetic predispositions and behavioral patterns into clinical care and public health initiatives can significantly reduce eye disease prevalence and improve patient life quality.

Glaucoma and age-related macular degeneration are the leading causes of irreversible vision loss in individuals over 60 years of age. This review consolidates current data on the epidemiology, shared genetic factors, and pathophysiological mechanisms underpinning their coexistence, and outlines prospects for personalized prevention and therapy. Common modifiable risk factors comprise cigarette smoking, arterial hypertension, and dyslipidemia. Chorioretinal hypoperfusion, mitochondrial dysfunction, activation of the NLRP3 inflammasome, and impaired glymphatic elimination of amyloid contribute to neurodegeneration both in the macula and in the optic nerve area. Treatment prospects include comprehensive vascular and neuroprotective regimens, targeted complement modulation, and the use of polygenic risk scores for patient stratification and longitudinal monitoring.

Glaucoma, one of the leading causes of blindness, often develops asymptomatically, necessitating early diagnosis and prediction of the progression rate of glaucomatous optic neuropathy (GON). Purpose. To develop a classification model using machine learning methods for predicting the rate of GON progression, and to identify the most significant predictors of progression in patients with newly diagnosed early primary open-angle glaucoma (POAG). Material and methods. The study included 59 patients (59 eyes) with early POAG, categorized into three groups based on the expert assessment of GON progression rate over a 36-month follow-up using dynamic morphofunctional evaluation. A classification model incorporating 35 clinical parameters, including optical coherence tomography (OCT) and OCT-angiography (OCT-A) data, was developed using partial least squares discriminant analysis (PLS-DA). Results. Over the 36-month follow-up, slow GON progression was recorded in 21 patients, moderate in 18, and rapid in 20. The mean progression rates were −0.77±1.27%/year for visual field area, −1.21±1.48 µm/year for retinal nerve fiber layer (RNFL) thickness, and −1.23±1.77 µm/year for ganglion cell complex (GCC) thickness. The model demonstrated sensitivity of 90%, specificity of 95%, and efficiency of 92%. The most significant predictors of GON progression were mean vessel density in the deep vascular plexus of the macular region (wiVD_Deep), choriocapillaris dropout in the inferior-nasal peripapillary region, choroidal thickness in the fovea, and lamina cribrosa thickness. Conclusion. The developed model effectively classifies patients based on the predicted progression rate of GON, which is important for individualized approach to glaucoma treatment planning.

Introduction. Acne is a chronic, recurrent, and inflammatory skin disease that that can have significant aesthetic and psychological impacts on patients. The first-line treatment for acne is isotretinoin, which exerts systemic effect, reducing sebum production and alleviating inflammation However, one of the most common complications associated with prolonged systemic retinoid use is dry eye syndrome, linked to meibomian gland dysfunction, warranting special attention from ophthalmologists. Purpose: to present a clinical case of a patient who underwent four months of systemic isotretinoin therapy for acne and subsequently developed ocular complaints. Methods. Comprehensive ophthalmological diagnostics were conducted, including patient history, biomicroscopy, and corneal staining with fluorescein. Additional assessment included non-invasive tear film breakup time, measurement of tear meniscus height, evaluation of the lipid layer thickness of the tear film, meibography, eyelid margin photography, conjunctival hyperemia analysis, and corneal fluorescein staining. Treatment included various groups drug classes such as moisturizing drops, reparative gels, corneal protectors, and glucocorticosteroids. A therapeutic eyelid massage was also performed. Results. After three months of active therapy, the patient exhibited significant improvement, with a marked reduction in subjective complaints, no corneal epithelial defects, and an increase in tear film breakup time. Long-term symptom remission was achieved after five months of therapy. Conclusion. This case highlights the importance of interdisciplinary collaboration between ophthalmologists and dermatologists in managing patients undergoing long-term systemic retinoid therapy for acne. Comprehensive ophthal- mological assessment using specialized diagnostic methods is essential for accurately evaluating the clinical picture of ocular conditions and administering timely, multi-faceted therapy. This approach enhances patients’ quality of life and helps prevent severe complications.