ИЗУЧЕНИЕ ВОЗМОЖНОСТИ РЕГУЛЯЦИИ АНГИОГЕНЕЗА IN VITRO С ПОМОЩЬЮ РЕКОМБИНАНТНЫХ ФРАГМЕНТОВ ИНГИБИТОРОВ АНГИОГЕНЕЗА ЭНДОСТАТИНА, ТУМСТАТИНА И PEDF

Neovascular diseases of visual organ such as age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, thrombosis of central retina vein and its branches, neovascular glaucoma, choroid and retina tumors have the leading positions in the list of ophtalmopatologies that result in blindness and incapacity. The variety of angiostatic medications of applied ophtalmology is scant. The aim of work was to study the possibile approaches to angiogenesis regulation in vitro with the help of recombinant fragments of natural inhibitors of angiogenesis such as endostatin, tumstatin and PEDF (pigment epithelial derived factor), and also their ability to be the base of potentially feasible and pharmacologically active substances. It is determined that endostatin, tumstatin and PEDF, as well as the comparison medication Bevacizumab in vitro have pro- or antiangiogenic influence. The direction of the biological effect depends on the cultivation conditions, peptide concentration in the cultural fluid and stage of angiogenesis. Неоваскулярные заболевания органа зрения, такие как возрастная макулярная дегенерация, ретинопатия недоношенных, диабетическая ретинопатия, тромбозы центральной вены сетчатки и ее ветвей, неоваскулярная глаукома, опухоли хориоидеи и сетчатки, занимают лидирующие позиции в перечне офтальмопатологии, приводящей к слепоте и инвалидизации, а также к социальной и психологической дезадаптации. Арсенал ангиостатических препаратов в практической офтальмологии скуден. Цель настоящей работы заключалась в изучении возможности регуляции ангиогенеза in vitro с помощью рекомбинантных фрагментов природных ингибиторов ангиогенеза эндостатина, тумстатина и PEDF (pigment epithelial derived factor) и применения их в качестве потенциально возможных фармакологически активных субстанций. Установлено, что in vitro эндостатин, тумстатин и PEDF, как и препарат сравнения бевацизумаб, оказывают про- или антиангиогенное действие. Направленность биологического эффекта зависит от условий культивирования, концентрации пептида в культуральной жидкости и этапа ангиогенеза.

Search and identification of thyroid hormones receptors in ocular tissues

Aim. To discover and identify thyroid receptors in ocular tissues by means of immunohistochemistry (IHC).Materials and methods.The objects of morphological studies were eyes enucleated for terminal painful glaucoma (n = 30). Thyroid receptors searching was performed in the retina and optic nerve, choroidal and optic nerve vessels. IHC reaction was considered as follows: negative — specific cellular staining is absent or less than 10 % cells are stained; mild positive — 10‑30 % cells are stained (+); moderate positive — 30‑75 % cells are stained (++); highly positive — more than 75 % are stained (+++). Results: Intensive (4+) IHC staining was revealed in the nuclei of inner and outer nuclear and ganglion cell layers. Mild positive (+) staining was detected in the inner segments of photoreceptors. Granular (3+) IHC staining was revealed in the nuclei of optic nerve glia. In choroidea, endotheliocytes nuclei and 20 % stromal cells nuclei were stained. IHCreaction was detected in the cytoplasm of retinal pigment epithelium.Conclusion. The data obtained account for the mechanism of neurohumoral associations at the cellular level. According to these data, eye can be considered as a target for thyroid hormones. The causes of morphological and functional abnormalities of visual analyzer peripheral part in thyroid gland disorders are revealed as well

Морфологические основы глаз-тиреоидной ассоциации

PURPOSE: Search and identification of thyroid hormone receptors in the structures of the eye by means of immuno- histochemistry analysis (IHC). METHODS: Enucleated eyes of the patients with terminal painful glaucoma (n=30) were the object of morphological research. The search of thyroid hormone receptors was conducted in the retina and optic nerve, ciliary body and its appendixes, trabecular tissue, vessels of choroidea and optic nerve. Antibodies to thyroid hormone receptor THRalfa monoclonal («Diagnostic BioSystem» company, dilution 1:50) and rabbit polyclonal antibodies Anti-Thyroglobulin («Abcam» company, dilution 1:100) were used as primary antibodies (AT). IHC reaction was estimated as follows: - the absence of specific cell color or the presence of less than 10% of stained cells out of all examined area was considered a negative reaction; - a mild positive reaction was considered in case of 10 to 30% staining (+ cells); - moderate positive reaction was in case of the marker expression in 30-75% (++ cells); - marker expression that exceeded 75% was considered a pronounced reaction (+++); - intensive reaction - 100% stained cells (++++). RESULTS: Intensive (4+) positive IHC was discovered in the nuclei of external and internal granular layers of the retina, in the nuclei of the ganglion cells; mild positive staining (1+) was observed in the internal segments of the photoreceptor cells processes. Granule IHC staining (3+) was revealed in the nuclei of the optic nerve glial elements. In the choroidea endotheliocyte nuclei and nuclei of 20% of stroma cells of vascular membrane were stained. There was a marked IHC reaction in the cytoplasm of pigment epithelium cells. Positive staining was observed in the cytoplasm and the nuclei of trabecular endothelial cells, as well as in the nuclei of fibrocytes forming trabecular stroma. Nuclei staining of 80% smooth muscle cells with intensive 3+ and mild cytoplasmic staining 1+ was noted in the ciliary muscle. Pigment and amelanotic epithelium nuclei as well as the nuclei of vessel endothelium cells were stained intensively (3+) in the ciliary body proccesses. CONCLUSION: Conducted investigations help give a morphological base to eye-thyroid association, as well as explain the possible mechanisms of disthyroid optic neuropathy and ocular hypertension, and open-angle glaucoma prevalence in the population of patients with thyroid dysfunction.Цель. Поиск и идентификация рецепторов тиреоидных гормонов в структурах глаза методом иммуногистохимического анализа (ИГХ). методы. Объектом морфологических исследований стали энуклеированные глаза больных терминальной болящей глаукомой (n=30). Поиск рецепторов тиреоидных гормонов осуществляли в сетчатке и зрительном нерве, цилиарном теле и его отростках, в трабекулярной ткани, сосудах хориоидеи и зрительного нерва. Первичным антителом (АТ) служили АТ к рецепторам тиреоидных гормонов THRalfa monoclonal (фирма «Diagnostic BioSystem», разведение 1:50) и поликлональные кроличьи антитела Anti-Thyroglobulin (фирма «Abcam», разведение 1:100). ИГХ реакцию оценивали следующим образом: - отрицательной считали реакцию в отсутствие специфического окрашивания клеток или при наличии менее 10% окрашенных клеток от всей площади в зоне просмотра; - слабо положительной реакцию считали в случае окрашивания от 10 до 30% (+) клеток; - умеренно положительной считали реакцию в случае экспрессии маркера в 30-75% (++) клеток; - экспрессию маркера более 75% клеток расценивали как выраженную реакцию (+++); - интенсивная реакция - 100% окраска клеток (++++). РЕЗУЛЬТАТЫ. Интенсивная (4+) положительная ИГХ- окраска зафиксирована в ядрах наружного и внутреннего зернистых слоев сетчатки, в ядрах ганглиозных клеток; слабоположительная окраска (1+) - во внутренних сегментах отростков фоторецепторных клеток. Гранулярная ИГХ-окраска (3+) обнаруживалась в ядрах глиальных элементов зрительного нерва. В хориоидее окрашивались ядра эндотелиоцитов и ядра 20% клеток стромы сосудистой оболочки. ИГХ-реакция отмечалась в цитоплазме пигментного эпителия сетчатки. Положительная окраска зафиксирована в цитоплазме и ядрах эндотелиальных клеток трабекулярного аппарата, а также в ядрах фиброцитов, образующих строму трабекулы. В цилиарной мышце визуализировалась ядерная окраска 80% гладкомышечных клеток с интенсивностью 3+, а также слабая цитоплазматическая окраска 1+. В отростках цилиарного тела интенсивно окрашивались (3+) ядра пигментного и беспигментного эпителия, а также ядра эндотелиальных клеток сосудов. ЗАКЛЮЧЕНИЕ. Проведенные исследования позволяют подвести морфологические основы под глаз-тиреоидные ассоциации, объяснить возможные механизмы развития дистиреоидной оптической нейропатии и офтальмогипертензии, а также распространенность открытоугольной глаукомы в популяции больных с тиреоидной патологией

Роль иммунных реакций в патогенезе оптической нейропатии при нормотензивной глаукоме

PURPOSE: To analyze molecular and immunological mechanisms of optic neuropathy development in patients with normal tension glaucoma. METHODS: We have been studying serologic indicators of autoantibodies (AB) in patients with normal tension glaucoma (NTG, n=31), which were compared to corresponding parameters in patients with primary open-angle glaucoma (POAG, n=30). The control group consisted of 25 somatically healthy individuals without ophthalmic pathology and clinical symptoms of systemic autoimmune diseases. For the immunological part of the research we used a wide range of antigens: ENO-1, MBP, NSE, Tβ4, α-crystallin, rhodopsin, GAPDH, actin, α-fodrin. The antibody formation in blood serum was determined with the use of the enzyme-linked immunosorbent assay (ELISA). Antibodies concentration in the blood serum was reflected in a spectrophotometric indicator measured in standard units of optical density. RESULTS: Systemic immune disorders in patients with both forms of glaucoma were revealed. In the NTG group the level of AB to rhodopsin decreased from 1.13±0.13 (Mean±SD) to 0.91±0.19 (p=0.00002, pЦЕЛЬ. Изучение роли иммунных реакций в механизмах оптической нейропатии при нормотензивной глаукоме. МЕТОДЫ. Изучали серологические показатели аутоантител (АТ) в крови пациентов с нормотензивной глаукомой (НТГ, n=31); которые сопоставляли с данными при первичной открытоугольной глаукоме (ПОУГ, n=30). Контрольную группу составили 25 соматически здоровых лиц без офтальмопатологии и клинических признаков системных аутоиммунных заболеваний. Для иммунологических исследований использовали широкий спектр аутоантигенов: ENO-1, MBP, NSE, Tβ4, α-кристаллин, родопсин, GAPDH, актин, α-фодрин. Реакции антителообразования в сыворотке крови оценивали методом иммуноферментного анализа. Концентрацию антител в сыворотке отражал спектрофотометрический показатель, который выражался в условных единицах оптической плотности. РЕЗУЛЬТАТЫ. Выявили нарушения системного иммунитета при обеих формах глаукомы. При НТГ снижался уровень АТ к родопсину с 1,13±0,13 (Mean±SD) до 0,91±0,19 (p=0,00002,

Гемодинамические нарушения в магистральных сосудах глаза и орбиты при эндокринной офтальмопатии как фактор риска развития оптической нейропатии

PURPOSE: The search and identification of factor revealing the hemodynamic disturbances in magistral ocular and orbital blood vessels in endocrine ophthalmopathy (EOP) increasing the risk of the optic neuropathy development. METHODS: 86 patients with EOP were examined. EOP was associated with Graves' disease (GD, n=72, 144 orbits) and autoimmune thyroiditis (AIT, n=14, 28 orbits). All patients were examined by an ophthalmologist and an endo-crinologist. The diagnostic of GD and AIT was based on the medical history, examination, the level of thyroid hormones (free T4, free T3), thyroid-stimulating hormone (TSH), rTSH antibodies and thyroid sonography. Normal range for TSH levels was 0.25-3.5 mlU/l; free Т4 - 9.0-20.0 pmol/L; free ТЗ - 4.26-8.1 pmol/L. Patients with EOP were evaluated using the EUGOGO protocol. Every orbit was assessed separately. Ophthalmic examination included patients history and clinical assessment of EOP. All patients underwent similar eye examination (visometry, perimetry, biomicroscopy, tono-metry, ophthalmoscopy, Hertel exophthalmometry). Orbit pathology was verified by multispiral computed tomography. Orbit echography was carried out for all patients. Eyeball, retrobulbar space and magistral vessels were the anatomic objects of investigation. Blood flow was examined by ultrasound diagnostic system Voluson 730 PRO («Kretz», Austria) in regimen of triplexic screening (B-regimen, CDK in combination with impulse value dopplrography). Hemodynamic indices were analysed in a. ophthalmica, a. et v. retinae centralis, a. ciliaris posterior brevis et longae. Thyroid dysfunction type, endocrine disease duration, patient's age, orbital inflammation and the compressive factor were considered as factors of hemodynamic orbit disturbances. RESULTS: Different hemodynamic disturbances were present in all patients with EOP (100%). Statistic correlative analysis showed, that thyroid dysfunction is one of the most important factors, determining hemodynamic disturbances of orbit blood flow. The severity of these disturbances depended on the type of thyroid dysfunction. The obtained data showed that the age of the patient and the duration of the endocrine disease is the important factor of the hemodynamic disturbances of orbit blood flow in EOP. The age (over 50) and the duration of the disease result in hemodynamic disturbances, reaching the value of «chronic eye ischemic syndrome». The intensity of autoimmune inflammation was revealed to determine the depth of hemodynamic disturbances in orbit. At the same time the severity of EOP reflected intraorbital pressure that may cause hemodynamic disturbances changing the blood flow in the orbit. CONCLUSION: Factors determining the character of hemo-dynamic disturbances in main vessels of the eye and orbit in EOP are found and identified such as thyroid dysfunction type, orbital inflammation intensity, compressive factor, endocrine disease duration and the age of the patient.ЦЕЛЬ. Поиск и идентификация факторов, определяющих гемодинамические нарушения в магистральных сосудах глаза и орбиты при эндокринной офтальмопатии (ЭОП), повышающие риск развития оптической нейропатии. МЕТОДЫ. Обследованы 86 пациентов с ЭОП, ассоциированной с диффузным токсическим зобом (ДТЗ, 72 человека, 144 орбиты) и аутоиммунным тиреоидитом (АИТ, 14 человек, 28 орбит). Все пациенты были осмотрены офтальмологом и эндокринологом. Диагноз ДТЗ и АИТ устанавливали на основании анамнеза, осмотра, уровня тиреоидных гормонов (св.Т4, св.ТЗ), тирео- тропного гормона (ПТ), показателей АТ к рТТГ, АТ-ТПО, АТ-ТГ, эхографии щитовидной железы. Границы нормы для базального уровня ТТГ - 0,25-3,5 мЕд/л; св.Т4 - 9,0-20,0 пмоль/л; св.ТЗ - 4,26-8,1 пмоль/л. ЭОП верифицировали по протоколу EUG0G0. Каждую орбиту оценивали отдельно. Офтальмологический осмотр включал: сбор жалоб, анамнез, клиническую оценку ЭОП. Всем пациентам проводили: визометрию, периметрию, биомикроскопию, тонометрию, офтальмоскопию, экзофтальмометрию по Гертелю. Структуры орбиты исследовали мультиспиральной компьютерной томографией. Всем пациентам проводили эхографию орбиты. Анатомическими объектами исследования служили: глазное яблоко, ретробульбарное пространство и его магистральные сосуды. Кровоток исследовали на ультразвуковой диагностической системе Voluson 730 PRO («Kretz», Австрия) в режиме триплексного сканирования (В-режим, ЦДК в комбинации с импульсно-волновой допплерографией). Анализировали гемодинамические показатели в a. ophthalmica, a. etv. retinae centralis, a. ciliaris posterior brevis et longae. В качестве факторов, определяющих гемодинамические нарушения в орбите, рассматривали: уровень тиреоидных гормонов и ТТГ, длительность заболевания щитовидной железы, возраст пациента, орбитальное воспаление, компрессионный фактор. РЕЗУЛЬТАТЫ. У всех пациентов с ЭОП (100%) присутствовали различные гемодинамические нарушения. Статистический корреляционный анализ показал, что отклонение уровня тиреоидных гормонов и ТТГ от нормы - один из наиболее значимых факторов, определяющих гемодинамические нарушения орбитального кровотока. Выраженность этих нарушений зависит от вида дисфункции щитовидной железы. Полученные результаты свидетельствовали о том, что возраст и длительность заболевания щитовидной железы являются важными факторами, определяющими гемодинамические нарушения орбитального кровотока при ЭОП. С увеличением возраста (после 50 лет) и длительности заболевания гемодинамические нарушения усиливаются, достигая значений, укладывающихся в понятие «хронического глазного ишемического синдрома». Выявили, что интенсивность аутоиммунного воспаления определяет глубину гемодинамических нарушений в орбите. Наряду с этим тяжесть ЭОП отражает интраорбитальное давление, что также может вызывать гемодинамические нарушения, изменяя кровоток в орбите. ЗАКЛЮЧЕНИЕ. Найдены и идентифицированы факторы, определяющие характер гемодинамических нарушений в магистральных сосудах глаза и орбиты при ЭОП. К ним относятся: вид дисфункции щитовидной железы, интенсивность орбитального воспаления, компрессионный фактор, длительность заболевания щитовидной железы и возраст пациента

Like a bolt from the blue : phthalocyanines in biomedical optics

The purpose of this review is to compile preclinical and clinical results on phthalocyanines (Pcs) as photosensitizers (PS) for Photodynamic Therapy (PDT) and contrast agents for fluorescence imaging. Indeed, Pcs are excellent candidates in these fields due to their strong absorbance in the NIR region and high chemical and photo-stability. In particular, this is mostly relevant for their in vivo activation in deeper tissular regions. However, most Pcs present two major limitations, i.e., a strong tendency to aggregate and a low water-solubility. In order to overcome these issues, both chemical tuning and pharmaceutical formulation combined with tumor targeting strategies were applied. These aspects will be developed in this review for the most extensively studied Pcs during the last 25 years, i.e., aluminium-, zinc- and silicon-based Pcs

Results of research for correspondence of retinas in patients with concomitant strabismus in different division ways of visual fields

Purpose.  A  comparative  analysis  of  results  in  the  study  for  a correspondence  of  retinas  obtained  using  mechanical,  anaglyph  and raster conditions of separation of visual fields, taking  into account the objective and subjective angles of strabismus.Material and methods. There were in the study follow-up 240 patients with concomitant strabismus aged 6 to 17 (mean 10.8±0.24) years: with convergent strabismus – 190 patients, with divergent strabismus – 50 patients. All patients underwent a standard ophthalmological examination. In  the  complex  of  additional  orthoptic  examination  we  applied: determination  of  deviation  value  and  study  of  retinal  correspondence using the synoptophore by two methods: measurement of deviation value by means of prisms, study of retinal correspondence by means of classical (with raster separation of visual fields) Bagolini test and modified (with anaglyph separation of visual  fields) Bagolini  test. The deviation value using the synoptophore was determined in two ways: 1) using binocular conditions (both test objects are initially highlighted); 2) using monocular alternation. To determine  the value of deviation  in conditions as close as possible to the natural cover-uncover test and alternating cover-test with prisms was used.Results. It was  found  that  the value of deviation measured on  the synoptophore by the first method was comparable to the value of deviation determined using a cover-uncover test (t=1.74; p=0.083). The deviation measured on the synoptophore by the second method was comparable to  the  deviation  measured  using  the  alternating  cover  test  (t=0.89; p=0.37), exceeding the deviation value on the synoptophore by the first method and with the cover-uncover test by an average of 4.2±0.03°. In a comparative analysis of the results of the retinal correspondence study using different methods  separately under  the objective and  subjective angle  of  strabismus,  it was  detected  that  the  results  of  the  study  are comparable in most patients, and the difference observed in other cases reflects the influence of mechanical, anaglyphic or raster conditions for separating the visual fields.Conclusions. The results in the measurement of the strabismus angle obtained in the study using the synoptophore with binocular observation conditions (both test objects are initially highlighted) and using a coveruncover  test  with  prisms  can  be  comparable  and  characterize  the value of only  tropia without phoria. The results  in  the measurement of the strabismus angle obtained  in  the study on synoptophore using  the monocular alternation and using alternating cover-test with prisms, can also  be  comparable  and  characterize  in  both  cases  the  total  value  of the deviation of  the eye,  including both  tropia and phoria. The  results of  the  study of  retinal correspondence using mechanical, anaglyph or raster conditions  for a separation of visual  fields  in most patients are comparable,  but  if  it  is  a  subject  to  the  same  principles  of  projecting images to the central and peripheral areas of the retina

The results of the use of alternating presentation of the stimuli in orthoptic treatment in children

Purpose. To evaluate the results in the use of different modes for alternating presentation of stimuli in the orthoptic treatment of strabismus in children.Material and methods. The study included 41 patients with a nonparalytic strabismus (30 children with esotropy and 11 children with exotropy) aged from 7 to 16 years. For additional studies of binocular functions, we used a modified Bagolini test and our own stereo-test created for the conditions of anaglyph separation of visual fields. During the first examination the results with all the used stereo-tests (the Flytest, the Lang-test, and the stereo image that we created) were negative. Besides to the static presentation of test images, three different modes of alternating presentation of stimuli were used: 1) with consecutive monocular presentation of visual stimuli corresponding to the right and left eye; 2) with the presence of an empty interval between monocular phases; 3) with the presence of a binocular phase between monocular phases. The duration of the monocular and binocular phases, as well as the empty interval, was regulated by the researcher. Depending on the results of the examination, an optimal mode of alternative presentation of stimuli for the orthoptic tr eatment was selected individually.Results. In the duration of the monocular phase 50 ms in combination with the duration of an empty interval 50 ms, the majority of children (32 of 41) with strabismus were able to have stereovision. As a result of orthoptic exercises, the number of patients capable of bifoveal fusion increased from 24.4% to 48.8%. Stereovision appeared in 39% of children according to the Fly-test and in some cases according to the Lang-test. In all children with moderate amblyopia the visual acuity increased on average from 0.23±0.01 to 0.52±0.05 (p<0.001), in children with mild amblyopia the visual acuity increased on average from 0.66±0.02 to 0.93±0.01 (p<0.001). A reduction of the strabismus angle or an elimination of postsurgical microdeviation occur in one-third of children.Conclusion. The proposed method for the study of binocular functions in patients with strabismus allows to evaluate the ability to the bifoveal fusion and stereo perception not only with static presentation of visual stimuli, but also with the use of different modes of their alternating presentation. The most favorable mode for the elimination of functional inhibition is the mode of alternating presentation of stimuli with the presence of an empty interval not less than 50 ms between the monocular phases, which are also not less than 50 ms. This mode with the combination of monocular phase duration and empty interval duration in the range from 30 to 60 ms creates the most favorable conditions for the appearance of the stereo effect in the majority of the patients. The use of optimal individually chosen regime of alternating presentation of the stimuli allows to improve significantly the binocular functions, to increase the visual acuity, and in some cases to reduce the angle of strabismus or to eliminate postsurgical microdeviations

Application of the Modified Вagolini Test in the Diagnosis of Binocular Vision Disorders

The work is devoted to one of the most actual problems of current strabismology — the development of effective ways to study binocular vision.The purpose — to study the effectiveness of the developed modification of the Bagolini test in the diagnostics of binocular disorders.Patients and methods. 240 patients with non-paralytic strabismus aged from 6 to 17 (on average 10.8 ± 0.24) years were observed. There were 190 patients with converging strabismus and 50 patients with diverging strabismus. The control group consisted of 180 children aged also from 6 to 17 (on average 10.9 ± 0.3) years without ophthalmopathology. All children were examined for the character of vision using a Worth-test, the classic Bagolini test (CTB), and the developed modified Bagolini test (MTB). If the patient has a strabismus angle, the study was performed in two variants: without prismatic deviation compensation (under the subjective angle of strabismus — SU) and under full prismatic compensation (under the objective angle of strabismus — OU). For qualitative assessment of binocular vision with MTB, static presentation of the test image was used, for quantitative assessment — alternating (alternate presentation of details corresponding to the right and left eyes).Results. The qualitative evaluation data obtained with the help of MTB made it possible to differentiate patients with non-permanent regional functional scotoma of suppression (FSP) and patients with stable bifoveal fusion among children with binocular vision by color test, and to distinguish patients with regional stable FSP and total FSP among children with monocular vision by color test. In the study under SU, the sensitivity of the method was 97.8 % and specificity 96.2 %, under OU — 96.6 % and 92.7 %, correspondingly. Using quantitative evaluation, it was found that the minimum duration of monocular phases required to eliminate functional inhibition in children with total FSP is twice as long as in children with regional FSP (z = 6,303, df 52, p < 0.001 according to the Mann — Whitney criterion).Conclusion. Thus, the modified Bagolini test developed by us is an effective way of qualitative and quantitative assessment of the state of binocular vision. The method has a high sensitivity and specificity, combines the capabilities of anaglyphic and phase haploscopy, and can be used for a personalized approach to the selection of conditions and modes of functional correction of binocular disorders, as well as for monitoring binocular vision during treatment

Мethod of Functional Treatment of Refractive Amblyopia in Children Using Alternating Presentation of Stereo Stimules

The research is devoted to one of the most urgent problems of modern ophthalmology — the search for new approaches to creating effective methods of functional treatment of refractive amblyopia using computer technologies.The purpose of the work is to evaluate the effectiveness of computer technology with consistent use of alternating and non-alternating modes of presentation of stereostimulars in the functional treatment of refractive amblyopia in children.Patients and methods. 105 patients with refractive amblyopia at the age of 7 to 17 (on average 11.45 ± 0.3) years were observed. Refraction was hypermetropic in 31 (29.5 %) children, myopic in 62 (59 %) and mixed astigmatism was detected in 12 (11.5 %) children. The visual acuity of the best-seeing eye was on average 0.76 ± 0.01, that of the worse-seeing eye was 0.68 ± 0.02, and that of the binocular eye was 0.77 ± 0.01. In the study on synoptophore, all children had normal correspondence of the retina with the fusion reserves, which were significantly reduced. The character of vision was binocular in all children, but the presence of stereo vision on the Fly test was detected in 96 (91.4 %) children, and on the Lang test only in 73 (69.5 %) children. Functional treatment was performed using computer programs with sequential use of modes of alternating and non-alternating presentation of stereo stimuli with certain characteristics.Results. As a result of the course of treatment, the number of children with stereo vision increased from 96 (91.4 %) to 105 (100 %) on the Fly test and from 73 (69.52 %) to 97 (92.4 %) on the Lang test. In addition, there was a significant increase in visual acuity (on average, up to 0.96 ± 0.01 for the best-seeing eye, up to 0.9 ± 0.01 for the worse-seeing eye, and up to 0.97 ± 0.01 binocularly). There was also an increase in positive fusion reserves by 1.5 times and negative reserves by 1.3 times.Conclusion. Visual training with computer programs that provide the consistent use of modes of alternating and non-alternating presentation of stereo stimuli with certain characteristics is an effective way of functional treatment of refractive amblyopia in children, allowing to increase monocular and binocular visual acuity, improve the performance of fusion reserves and improve the state of stereo vision