This review systematizes data on the anatomy of the optic nerve from an applied perspective. It describes in detail the embryogenesis, structure, and topography of each of its four segments (intraocular, intraorbital, intracanalicular, and intracranial). Considerable attention is paid to variations in the relationship between the optic nerve and the sphenoid sinus, taking into account the structural features of the latter. The review presents variations in the frequency of optic nerve types according to M.C. DeLano et al. (depending on their relationship with the sphenoid sinus), including in the presence of optic canal dehiscence, Onodi cells, and pneumatization of the anterior clinoid process; it also describes variants of the topography of the sphenoid sinus and the presence of additional septa within it.
The adverse consequences of friction in biological structures include wear and discomfort. The tribological model of the eye comprises two rubbing surfaces and lubrication provided by the complex composition of the tear film. Eyelid movement corresponds to the hydrodynamic regime of the Stribeck curve. This review considers various components of the tribological system of the visual organ, including the "lid wiper", the structure of the "brushes", the role of the glycocalyx, and tear film components relevant to friction. The study separately analyzes the patterns and mechanisms of friction under dry eye conditions, and presents in detail the effects of contact lenses on the tribological components of the ocular surface. The review identifies a number of conditions and diseases that affect ocular surface wear and microtrauma, and outlines possible directions for the development of tribological analysis in clinical practice and approaches to reducing friction between ocular surfaces.
In modern cataract surgery, the ophthalmologist aims not only to remove the lens but also to optimize the patient's refractive status. Refractive lens exchange allows correction of presbyopia and reduces spectacle dependence, particularly in patients with high myopia who are not suitable candidates for corneal procedures. OBJECTIVE:The study evaluated the postoperative outcomes of trifocal intraocular lenses (IOLs) implantation for correction of high myopia and myopic astigmatism. MATERIAL AND METHODS:This retrospective study, conducted at the Eye Microsurgery Ophthalmological Center in Chișinău (January-December 2023), analyzed data from 40 patients (75 eyes) who underwent refractive lens exchange with trifocal IOL implantation (Alcon PanOptix/PanOptix Toric). The patients were selected according to specific criteria, and all underwent comprehensive preoperative assessment. Surgery was performed by phacoemulsification under local anesthesia, followed by postoperative care. The 1-month follow-up included measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and corrected intermediate visual acuity (CIVA). RESULTS:The patients included in our study received two types of trifocal IOLs. Alcon IQ PanOptix IOLs were implanted in 81% of cases, and Alcon IQ PanOptix Toric IOLs - in 19%. After surgery, patients showed a substantial improvement in visual acuity: UDVA increased by 81%, UIVA - by 39%, uncorrected near visual acuity (UNVA) - by 12%, and CDVA and corrected near visual acuity (CNVA) - by 2%. Peripheral retinal degeneration was the most common ocular pathology - 47% (35 eyes). CONCLUSION:Trifocal IOL implantation in high myopia with myopic astigmatism provides high visual acuity, spectacle independence, and requires careful preoperative assessment.
Preeclampsia is a leading cause of maternal and perinatal mortality, which makes the search for methods of early preclinical diagnosis highly relevant. Ocular microcirculation, owing to its similarity to cerebral and placental vessels, represents a unique "window" for assessing systemic endothelial dysfunction. The study provides a comprehensive analysis of current data on the association between impaired autoregulation of retinal and choroidal blood flow in preeclampsia and the risk of systemic hemodynamic and cerebrovascular complications. Unlike physiological vasodilation, preeclampsia is characterized by autoregulatory failure, which leads to hyperperfusion and a risk of vasogenic cerebral edema in cerebral vessels, while in the retina it manifests as vasospasm detectable as early as the first trimester. Choroidal changes remain contradictory and reflect complex systemic hemodynamic shifts. Impaired ocular vascular hemodynamics serves as an early marker of systemic endotheliopathy, and its monitoring represents a promising tool for risk stratification of cerebrovascular and long-term cardiovascular complications.
The prevalence of high myopia and primary open-angle glaucoma is rapidly increasing, complicating differential diagnosis because of overlapping morphological changes in the optic nerve head and lamina cribrosa. Both pathologies are accompanied by changes in the optic nerve head and lamina cribrosa, which makes interpretation of optical coherence tomography findings challenging. Analysis of literature sources shows that the most significant criteria include lamina cribrosa parameters (thickness, curvature, deformation index), features of peripapillary atrophy, the pattern of retinal nerve fiber layer thinning, and biomechanical parameters, including corneal hysteresis. Comparison of these signs helps differentiate myopic and glaucomatous changes and improves the accuracy of differential diagnosis between high myopia and primary open-angle glaucoma.
