BACKGROUND: Hamartomas (from the Greek hamartia—error) are developmental anomalies caused by abnormal proliferation of cells in their physiological location. Among them, combined hamartoma of the retina and retinal pigment epithelium is of particular interest due to its rarity, diverse clinical manifestations and the challenges associated with interpreting instrumental diagnostic findings. AIM: The work aimed to analyze the differential diagnostic features of combined hamartoma of the retina and retinal pigment epithelium in children based on clinical examination and optical coherence tomography data. METHODS: A single-center, cross-sectional retrospective study was conducted. The study included medical records of patients examined at the Helmholtz National Medical Research Center of Eye Diseases between 2016 and 2025. Clinical and morphological characteristics of combined hamartoma of the retina and retinal pigment epithelium in children were analyzed with emphasis on identifying a set of differential diagnostic criteria. RESULTS: The study included 14 children (16 eyes) with a confirmed diagnosis of combined hamartoma of the retina and retinal pigment epithelium. The age of the children at examination ranged from 1.4 to 8 years, with a mean of 6 ± 2.8 years. The retrospective analysis revealed that the most typical manifestation of combined hamartoma of the retina and retinal pigment epithelium was the presence of an epiretinal membrane. In some cases, signs of traction syndrome were observed, characterized by specific retinal architectural changes on optical coherence tomography: mini-peaks, maxi-peaks, the “omega sign” and the “shark teeth” phenomenon. In addition, some patients exhibited retinal thickening at the site of the hamartoma, the development of choroidal neovascularization and other traction-related changes. These findings confirm that the combination of ophthalmoscopic appearance, patient history and structural characteristics identified by optical coherence tomography provides the most comprehensive assessment of disease course and allows differentiation from vitreoretinal traction syndromes of other etiologies. CONCLUSION: Combined hamartoma of the retina and retinal pigment epithelium is a very rare, often unilateral developmental anomaly of the retina that can lead to significant visual loss in cases with central fundus involvement. The condition has characteristic ophthalmoscopic and optical coherence tomography features, knowledge of which enables timely diagnosis and appropriate management of affected patients.

Few studies have analyzed choroidal neovascularization (CNV) in children because of the low incidence of this complication in pediatric ophthalmology. However, given the significant effect on visual acuity and diagnostic difficulties in children, the study of this complication is relevant. AIM: This study aimed to analyze the etiological structure and clinical features of CNV in children. MATERIAL AND METHODS: From 2014 to 2022, 61 eyes of 54 children (26 girls and 28 boys) had CNV. The patients underwent standard ophthalmologic examination and optical coherence tomography (OCT) and OCT angiography (OCTA) of the macular zone and optic disc using the RS-3000 Advance 2 Tomograph (Nidek, Japan). RESULTS: At the time of CNV diagnosis, the children were 5–17 years old, with a mean of 11±3 years. In 30 children (55.6%), CNV was caused by inflammatory lesions of the retina and choroid. Of these cases, 11 occurred during remission, whereas 21 occurred alongside pathologies of the retina, choroid, and optic nerve of noninflammatory genesis (8 of which were associated with Best’s disease). In three children, CNV was considered idiopathic. The development time of postinflammatory CNV ranged from 1 month to 12 years, with an average of 7.3±5 months from disease onset. Type 2 CNV was found in most cases (48 eyes, 78.7%). CONCLUSION: CNV is a rare complication of various ocular diseases in children. In our cohort, it was most frequently observed in children with inflammatory lesions of the retina and choroid, even during remission. Patients at risk of CNV must be actively monitored because it occurs in various forms.

AIM: To investigate the role of proteolytic enzymes and their inhibitors in endogenous uveitis in children and develop new diagnostic criteria. MATERIAL AND METHODS: A total of 76 children (135 eyes) aged 3 to 17 years with uveitis were examined. All children underwent standard ophthalmological examination, posterior segment optical coherence tomography (OCT) was performed if required. Location, course, and activity of uveitis were assessed as per criteria developed by the International Uveitis Study Group. All patients underwent tear and serum biochemistry analysis, aqueous humor was tested if surgical treatment was required. Alpha-2-macroglobulin (α2-MG), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinases 1 (TIMP-1), urokinase-type plasminogen activator (uPA), and plasminogen (PG) levels were determined. Concentrations of α2-MG were measured by an enzymatic method using a specific substrate Nα-benzoyl-DL-arginine 4-nitroanilide (DL-BAPNA). MMP-9, TIMP-1, uPA, and PG levels were determined using an enzyme linked immunosorbent assay (ELISA). A total of 64 children (84.2%) were followed-up. The analysis included 1143 tear, 283 serum, and 79 aqueous humor samples. RESULTS: Active uveitis was found to be associated with activation of proteolytic enzymes and their inhibitors resulting in increased tear uPA levels, as well as increased uPA, MMP-9, and TIMP-1 levels in aqueous humor. Tear uPA level exceeds 80.7 pg/mL in active uveitis, ranges from 46.6 to 80.6 pg/mL in moderate/subactive disease, is less than or equal to 46.5 pg/mL in inactive phase/remission; it is one of the objective criteria to determine uveitis activity. In patients with panuveitis, tear MMP-9, PG, and α2-MG levels were higher compared to the children with anterior and peripheral uveitis. CONCLUSION: New data on the role of the proteolysis system in the pathogenesis of endogenous uveitis in children have been obtained. New criteria for assessing uveitis activity and severity have been established based on proteolytic enzymes and their inhibitors levels in tear fluid. The obtained results can be used to develop targeted therapy.

AIM: This study aimed to analyze clinical cases of spontaneous macular hole (MH) closure in children and determine the optimal approach for managing patients with this disease. MATERIAL AND METHODS: Data from 32 patients aged 6–17 years (average: 11.3 years) were evaluated, including 32 eyes with a full thickness macular hole and 1 eye with a lamellar macular hole. All patients were treated in the Department of Pediatric Ocular Pathology of the Helmholtz National Medical Research Center of Eye Diseases in 2013–2023. They underwent a comprehensive ophthalmological examination, including optical coherence tomography (OCT) of the macular area. RESULTS: Spontaneous MH closure was observed in five eyes (15.2%) of five patients (15.6%). The etiological factor of the disease was ocular contusion in two cases, photodamage in one case, and an inflammatory process in the posterior segment of the eye in two cases. A small diameter MH (100–261 µm) and its overgrowth soon after formation were common to all patients, that is, less than 2 months in 3 of 5 children and within 6 months in all patients. CONCLUSION: Spontaneous closure of MH with a small diameter and in the early stages after its formation is rare in pediatric patients. For MH with a diameter of up to 200 µm according to OCT and the absence of other indications for surgical treatment, a wait-and-see approach for 3 months with regular (once a month) examination is recommended. In cases with MH closure tendency, continued follow-up is crucial; if it persists after 3 months or increases at any period of follow-up, surgical treatment is indicated.

Familial exudative vitreoretinopathy (FEVR) is a rare hereditary disease characterized by abnormal angiogenesis, presence of avascular zones on the periphery of the retina, and clinical manifestations ranging from an asymptomatic course to total retinal detachment. Surgical interventions are performed to eliminate vitreoretinal traction, epiretinal membranes, and retinal detachment. Studies of the surgical treatment outcomes of patients with FEVR are limited and findings are ambiguous AIM: To analyze surgical treatment outcomes of different stages of FEVR in childhood. MATERIAL AND METHODS: From January 2012 to October 2021 at the Helmholtz National Medical Research Center of Eye Diseases, surgical treatment was performed in 35 eyes of 33 patients aged 11 months15 years (average, 7 years). The effectiveness of treatment was evaluated 12 months after the treatment, and patients were examined every 36 months for 15 years (average 2 years). RESULTS: Аfter the primary surgery, a decrease in retinal traction in the posterior pole and periphery was achieved in all cases. Complete and incomplete reattachment was achieved in 30% and 70% of the eyes at stage 3 and in 12.5% and 87.5% of the eyes at stage 4, respectively. The long-term effectiveness rates of the intervention in stages 2, 3 (including complete and incomplete reattachment), and 4 were 100%, 87.5%, and 73.3%, respectively. Increases in the best-corrected visual acuity (BCVA) were observed in 83%, 50%, and 28.6% of the eyes in stages 2, 3, and 4, respectively. In other cases, successful surgical treatment allowed the preservation of visual functions. During the follow-up, visual acuity of 0.1 or more was maintained in 100%, 85.7%, and 36% of the eyes at stages 2, 3, and 4 of FEVR, respectively. CONCLUSION: Аnatomical and functional results of surgical treatment of FEVR correlate with the disease stage: the efficiency is greater in stage 2, and it was organ-preserving surgery in stage 5. To increase the effectiveness of treatment, early diagnosis of FEVR, laser coagulation of avascular zones, and active vessels are necessary, which makes it possible to stop the progression of the early stages of FEVR in 70%100% of cases and enables regular monitoring of patients for the timely detection of indications for additional laser coagulation or surgical intervention.

INTRODUCTION:This study aims to explore awareness, knowledge, and diagnostic/therapeutic practices in monogenic uveitis (mU) among uveitis experts. METHODS:This is an explorative, cross-sectional survey study. An anonymous, semi-structured, electronic survey was delivered to uveitis experts from the Autoinflammatory Diseases Alliance (AIDA) Network and International Uveitis Study Group (IUSG). We included respondents answering ≥ 50% of the survey. RESULTS:Seventy-seven participants rated their knowledge of mU as proficient (3.9%), adequate (15.6%), sufficient (16.9%), or poor (63.6%). When asked about the first mU gene they thought of, 60.4% mentioned NOD2, 3.9% mentioned NLRP3 or MEFV, and 49.4% provided incorrect or no answers. Success rates in clinical scenarios varied from 15.6% to 55.8% and were higher for ophthalmologists working in multidisciplinary teams (p < 0.01). Genetic testing was ordered for suspected mU by 41.6% of physicians. The availability of molecular techniques did not significantly differ based on geography (p > 0.05). The public healthcare system ensured a higher percentage of tests prescribed were obtained by patients compared to private insurances (p < 0.00). In terms of disease-modifying anti-rheumatic drugs (DMARDs), tumor necrosis factor-α inhibitors were the most familiar to uveitis experts. The difficulties with off-label therapy procedures were the primary barrier to DMARDs prescription for patients with mU and correlated inversely with the obtained/prescribed drug ratio for interleukin-1 (p < 0.01) and interleukin-6 (p < 0.01) inhibitors. CONCLUSIONS:This survey identifies proficiency areas, gaps, and opportunities for targeted improvements in patients care. The comprehensive outputs may inform evidence-based guidelines, empowering clinicians with standardized approaches, and drive an AIDA Network-IUSG unified effort to advance scientific knowledge and clinical practice.

AIM: Retinal and choroidal microvascular changes analysis in children with posterior and panuveitis using optical coherence tomography with angiography (OCTA) and determination of the possibility of using this method in activity assessment and disease monitoring. MATERIAL AND METHODS: 24 children with uveitis were examined. The age of children was from 8 to 18 years old (38 affected eyes). All included patients were divided into two groups: with posterior uveitis (27 eyes) and with panuveitis (11 eyes). In each of the groups, subgroups with active and inactive uveitis were identified. In addition to the standard examination OCTA was performed. Foveal avascular zone (FAZ) area, perfusion density in the superficial and deep vascular plexuses of the retina (SVRP, DVRP) and also in the layers of choriocapillaries and large and medium vessels of the choroid were studied. The control group consisted of 10 paired healthy eyes. RESULTS: Аll eyes with posterior and panuveitis were characterized by the irreversible decrease in perfusion density in DVRP. In eyes with active chorioretinitis was also detected the reversible decrease in perfusion density in SVRP, layers of choriocapillaries and large and medium vessels of the choroid. The formation of choroidal neovascular membranes (CNM) in patients with panuveitis with choroiditis was accompanied by the decrease in perfusion density at all levels studied. In eyes with chorioretinitis and CNM the decrease in perfusion density was detected in DVRP and the area of FAZ increased. CONCLUSION: The features of microcirculation in the chorioretinal complex identified using OCTA in children with posterior and panuveitis can improve the diagnosis and monitoring of these diseases.

AIM: To determine the content of plasminogen and urokinase activator of plasminogen in tears and blood serum and to identify correlations between the studied parameters and the clinical picture of uveitis. MATERIAL AND METHODS: One hundred thirty-three eyes with uveitis were examined in 74 patients aged 3 to 17 yr (average 10.453.35 yr). The content of the urokinase activator of plasminogen (UPA) was studied in 188 tear samples and 22 blood serum samples. The dynamics of UPA in tears were studied in 28 patients (51 eyes). The plasminogen content of 86 tear samples and 34 blood serum samples was studied. The dynamics of plasminogen in tears were studied in five patients (nine eyes). The concentrations of UPA and plasminogen were measured using the ELISA method and the kits ELISA kit for plasminogen activator, urokinase (UPA)/ELISA Kit for Plasminogen, Cloud-Clone Corp., USA). RESULTS: An increase in the content of UPA in the tears of children with uveitis was associated with higher inflammatory activity (p=0.04). An increase in the content of UPA in tears was associated with an increase in the degree of proliferative changes (p=0.04). An increase in the content of UPA and plasminogen in tears was found 12 months after surgery. There was an increase in the content of UPA (p=0.0001) and plasminogen in tears (p=0.009) and blood serum (p=0.09) with age. CONCLUSION: The content of UPA in tears increased significantly when severe uveitis was compared with inactive uveitis. An increase in the content of UPA in tears was associated with an increase in the degree of proliferative changes, which reflects the severity of the uveitis course. The content of UPA and plasminogen in tears and blood serum increased with age. An increase in UPA and plasminogen was observed within 12 months after surgery, with both returning to preoperative values by the third month of the postoperative period, which reflects the normal course of the wound healing process.

Changes in the macular zone of the retina, which have different etiopathogenesis, can occur with a similar ophthalmoscopic picture. AIM: To present the clinical case of a child with a congenital the optic disc pit, complicated by retinal detachment in the macular zone, who received long-term treatment for chorioretinitis. RESULTS: A 13-year-old child was referred to the Helmholtz National Medical Research Center for a diagnosis of an idiopatic chorioretinal inflammation in the right eye. For 2 years at home, the child received inpatient treatment, including anti-inflammatory, desensitizing, and antibacterial therapy, without changes in visual acuity, ophthalmoscopy, and optical coherence tomography (OCT) data. Based on a comprehensive assessment of OCT results of the macular area and the optic nerve head (presence of a peripapillary slit-like detachment of the neuroepithelium in the superior temporal and inferior temporal quadrants, detachment of the neuroepithelium in the macula), anamnesis (lack of a response to ongoing anti-inflammatory therapy), biomicroscopy, and ophthalmoscopy (on the right, the optic disc is oval, horizontally elongated, decolorized, along the horizontal meridian it is made of glial tissue, in the area of the papillomacular bundle and in the macula, there is a rough redistribution of pigment. On the left, the optic disc is oval, horizontally elongated, decolorized, the macula and the periphery without pathology), the diagnosis was made: a congenital anomaly in the development of the optic disc (optic disc pit) in both eyes complicated by retinal detachment in the macula on the right. The child underwent transpupillary laser coagulation of the retina in the parapapillar zone in the upper and lower temporal quadrants of the right eye. Upon further observation after 1 and 2 months, OCT data revealed positive dynamics of resorption of the subretinal fluid in the macular zone, and an increase in visual functions was noted. CONCLUSION: Сompetent interpretation and integration of the results of clinical and instrumental examinations and thorough analysis of anamnestic data make it possible to identify the pathology underlying structural disorders of the macular zone, which is of key importance in choosing the right treatment techniques and maintaining visual functions.

AIM: This study aimed to investigate the effectiveness of retinal laser coagulation in children with Coats disease. MATERIAL AND METHODS: The study included 118 patients who were examined and treated from January 2017 to December 2021; 102 of them were boys (86.6%) and 16 were girls (13.4%). All children had unilateral disease. All children underwent a comprehensive ophthalmological examination. Laser coagulation was performed in 113 patients using a green laser (532 nm). The number of retinal laser coagulation sessions ranged from 2 to 13 (on average 5.22.36) with intervals from 1.5 to 6 months (on average 2.010.46). RESULTS: Generally, retinal laser coagulation was effective in CD in 85.8% of cases (in 97 of 113 children). Effectiveness was 100% for vascular malformations and exudates outside the macula, 97.3% for vascular and exudative retinal changes involving the macular zone, 92.3% for local retinal detachment, 90.5% for widespread retinal detachment, 60.0% for subtotal retinal detachment, and 30.0% for total. Only those who had peripheral Coats disease symptoms were found to have visual acuity of 0.6 or above, both before and after treatment. Visual acuity did not exceed 0.1 in 92% of patients with vascular and exudative changes in the periphery and in the macula and in 94% with local and widespread retinal detachment. After successful retinal laser coagulation, 11 children (13.4%) had visual acuity of 0.4 or higher, 13 children (15.9%) had visual acuity between 0.1 and 0.3, 45 children (54.9%) had finger count of 0.09, and 13 children (15.9%) lack objective vision. CONCLUSION: Retinal laser coagulation using a laser with a wavelength of 532 nm is an effective method for treating CD at all stages, including cases of the disease with the development of retinal detachment.

Purpose: to study the hemodynamic parameters in the eye’s vessels in children with endogenous uveitis, depending on the localization and degree and activity of the inflammatory process.Patients and methods: 67 children aged 6 to 18 years were examined. Of these, 19 people (35 eyes) were diagnosed with anterior uveitis, 20 (38) — peripheral, 8 (14) — posterior, 10 (20) — panuveitis. There were subgroups according to the degree of inflammation activity in each group. There were 10 healthy children (20 eyes) in the control group. The maximum systolic (Vsyst), final diastolic (Vdiast) blood flow rate and resistance index (RI) in the ocular artery (GA), central retinal artery (CAC), posterior short ciliary arteries (ZCCA), central retinal vein (CVS) and superior ocular vein (VGV) were detected with the method of the Color Duplex Scanning (CDR).Results. The maximum systolic and final diastolic blood flow rates in GA decrease, and in panuveitis, on the contrary, increase in anterior uveitis on the location of active inflamation. In panuveitis, the blood flow rate in the HBV also increases. In peripheral uveitis, there is a decrease in systolic and diastolic blood flow rates and an increase in the resistance index in CAC and WCC. With posterior uveitis, the blood flow in the HBV slows down and the RI in the CAC and WCC increases.Conclusion. In children with active uveitis, according to the CDR, hemodynamic changes in the vessels of the eye are observed, it depends on the localization of the inflammatory process. They have multidirectional nature. In most cases, a decrease in blood flow rate and an increase in RI are detected. The study of the eye’s hemodynamics can be an additional criterion for assessing the activity of inflammation and the effectiveness of therapy, as well as differential diagnosis of various localization of the uveitis.

AIM: This study aimed to investigate the efficacy and safety of micropulse cyclophotocoagulation (MP-CPC) in the treatment of various types of glaucoma in children. MATERIAL AND METHODS: The study included 14 children (15 eyes) with uncompensated glaucoma of various etiologies, who underwent MP-CPC using the Cyclo G6 laser system (IRIDEX, USA). The intervention was considered absolutely effective when IOP reached 8 to 25 mm Hg without medications and without signs of progression of glaucoma, relatively effective, when the same criteria are achieved with hypotensive medications. RESULTS: The average age of children at the time of intervention was 8.51.5 yr (from 7 months to 17 yr). The average level of IOP before surgery was 28.51.1 mm Hg, 3 days after MP-CPC (18.871.04 mm Hg), while the absolute efficiency was 14.3%, relative 100%. By the end of the observation period (16 months; on average, 2.50.4 months), the average IOP was 24.41.31 mm Hg (average decrease, 14.3%), with absolute efficiency of 0% and relative of 66.7%. The average number of hypotensive medications received in instillations did not change significantly before and after MP-CPC and amounted to 3.450.22 and 2.910.39, respectively (p=0.167). Complications after MP-CPC were detected in six eyes (40%); in all cases, the appearance or increase of the inflammatory reaction in the anterior chamber was observed. In addition, in two eyes (13.3%). In addition, a slight mydriasis (45 mm) developed. CONCLUSION: MP-CPC is a safe and effective treatment for glaucoma in children with various etiologies. Further research is needed to evaluate the effectiveness of intervention in the long term and the safety of repeated procedures to achieve normal IOP and to develop individual schemes of MP-CPC.

AIM: This study aimed to determine the content of matrix metalloproteinase-9 (MMP-9) in the aqueous humor (AH) of the eyes in children with uveitis and its role during the disease. MATERIAL AND METHODS: Twenty children (20 eyes with uveitis) aged from 3 to 16 yr (11.253.43 yr on average) and three children with congenital cataract from the control group were examined. The concentration of MMP-9 was determined by enzyme-linked immunosorbent assay (ELISA) using the ELISA kit for MMP-9 (Cloud-Clone Corp, USA). The optical density of the samples was measured using a multifunctional photometer for Synergy microplates (BioTek, USA). RESULTS: Children with uveitis had a higher content of MMP-9 in the AH than children in the control group (p=0.006). An increase in the content of MMP-9 in the AH of the eyes was correlated with an increase in the degree of proliferative changes in the eye. CONCLUSION: The concentration of MMP-9 in the AH of the eyes correlates with the severity of proliferation, and its measurement can be used to assess the severity of the inflammatory process in the eye.

Tacrolimus is an effective immunosuppressive agent that is widely used in transplant surgery. Rare complications of its usage include optic neuropathy or maculopathy development. AIM: To present a clinical case of tacrolimus-induced optic neuropathy and retinopathy CLINICAL CASE. A family with a 17-year-old boy was referred to Helmoltz National Medical Research Center of Eye Diseases with complaints of sudden painless decreased vision in his right eye. The best-corrected visual acuity was the right eye of 0.3 and the left eye of 1.0. Ophthalmoscopy of his right eye revealed pigment mottling in the macula and paramacular region, mid-peripheral patchy pigment deposition in 2, 4, and 8 clock meridians. No pathological findings were revealed in his fellow eye. From the anamnesis, 15 years ago, the patient underwent liver transplantation (Alagille syndrome). From the moment of surgery to the date he received tacrolimus. Optical coherence tomography highlighted foveal smoothing, ellipsoid zone and retinal pigment epithelium disruption, macular and paramacular choroid thinning, and neuroretinal rim thickening. Computed microperimetry revealed a significantly decreased sensitivity in the central retinal zone of the right eye. Autofluorescence examination showed multiple punctate hypoautofluorescent spots in the macula and paramacula in the right eye, as well as hyperautofluorescent zones in the posterior pole in both eyes. Electric activity analysis has revealed decreased full-field electroretinogram parameters and P100 amplitude in visually-evoked potentials in the right eye and a decreased a-wave full-field electroretinogram of the left eye. The data provided by the parents suggest that the target tacrolimus concentration in plasma was exceeded 2 times just before the patient noticed vision impairment. Differential diagnoses included infectious and non-infectious posterior uveitis. CONCLUSION: The first case of combined retinopathy and optic neuropathy in adolescents induced by long-term tacrolimus treatment was described.

Despite dominant lung lesions, new coronavirus infection (COVID-19) can influence almost any organ, including eyes. According to modern data, frequency of eye damage by COVID-19 reaches 32%, and spectrum of clinical manifestations is diverse. Changes are observed both in the anterior (mainly conjunctivitis) and posterior (mostly retinal vascular thrombosis, optic neuritis, neuroretinitis) segments of the eye, and the timing of their occurrence varies from the first (sometimes the only) clinical symptoms of the disease to the development at the peak or during the period of convalescence from COVID-19. In children symptomatic COVID-19 infection is diagnosed less frequently than in adults, and ophthalmic manifestations are less investigated. This article describes a case of bilateral neuroretinovasculitis in a 17-year-old girl with a mild course of COVID-19, that arose 3 weeks after the onset of the disease, which broadens the understanding of ocular manifestations of COVID-19 in children. We emphasize that an ophthalmologist should know ocular manifestations of COVID-19, which can help in the diagnosis and further study of the frequency and spectrum of ophthalmic symptoms, especially in children

Aim: This study aimed to assess the functional and anatomical results of subtenon triamcinolone injections in children with retinitis pigmentosa (PR) and cystic macular edema (CME), refractory to local carbonic anhydrase inhibitors. Material and methods: We examined 11 children (9 girls, 2 boys) aged 9 to 17 years who underwent subtenon injections of triamcinolone (22 eyes). The follow-up period ranged from 1.6 to 33.1 months (average 9.711.6 months), the number of triamcinalone injections ranged from 1 to 11, averaging 3. Before and after injection, best corrected visual acuity (BCVA), the thickness and structure of the retina in the macular zone (optical coherence tomography [OCT] was performed by using the NIDEK RS-3000, Japan or the Spectralis, Heidelberg Engineering, Germany), and intraocular pressure (IOP) were assessed. Results: The CME height at the end of the observation period decreased in 10 cases (45.5%), and the average central retinal thickness decreased from 70 to 594 m (on average, 219.1183.4 m). In 12 eyes (54.5%), the CME height at the end of the observation period did not change significantly. BCVA improved in two eyes (9.1%) and did not change in the other cases. Two children (18%) developed ophthalmic hypertension in both eyes after two injections of triamcinalone. In one child, IOP returned to normal on the background of hypothetical therapy. In another child, due to non-compensation of IOP at the maximum hypotensive mode, sinus trabeculectomy was performed in both eyes, and IOP normalization was achieved. Conclusion: Subtenon injection of triamcinolone in children with CME against a background of PR is in most cases is an effective and safe method of treatment and can be recommended if carbonic anhydrase inhibitors are ineffective at reducing/ resorbing edema and maintaining or improving visual function. Considering that the action of triamcinolone is short lived, and its repeated injection is required, and the resorption of CME and an increase in visual acuity are not always achievable, it is necessary to continue the search for more effective treatment methods.

An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence, and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis, and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.

Retinitis pigmentosa (RP) is a genetically determined degenerative retinal disease characterized by primary progressive degeneration of rod and secondary degeneration of cone photoreceptors. Despite the fact that the central retinal zone remains relatively intact for a long time, the most common complication of RP is macular edema (ME). The causes of ME in patients with RP have not been finally established, and treatment approaches are controversial. This article presents the modern data on the pathogenesis, clinical aspects, diagnostic, and treatment methods of ME associated with RP.

Uveitis is the most common extraarticular manifestation of juvenile idiopathic arthritis (JIA); if not diagnosed and treated in time, it can lead to severe complications and loss of vision. This report describes a novel algorithm for screening, treating, and monitoring uveitis in children with JIA. Ophthalmic screening of children with JIA is based on individual risk factors for uveitis. Treatment strategies include use of local glucocorticoids at the initial stage, followed by non-biological and then biological immunosuppressive drugs in severe or refractory cases. Therapy initiation and discontinuation schemes are detailed, and the need for further research is emphasized.

Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB).Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes.Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease "remission" and "cure", both of which are relevant for reporting treatment outcomes.Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.