Background: Primary probing of the nasolacrimal duct remains the first-line surgical intervention for congenital nasolacrimal duct obstruction (CNLDO) in infants and young children. However, age-dependent success rates have been less thoroughly investigated. This systematic review and meta-analysis aims to evaluate the age-related success rates of primary probing in children with CNLDO. Methods: Systematic literature searches were performed in PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar in May 2025. A random-effects model was applied to estimate the overall success rate, while sensitivity analyses and publication bias assessments were performed to explore sources of variability. All statistical analyses were carried out using the “meta” and “metafor” packages in RStudio. Results: This meta-analysis reveals age-stratified success rates of primary probing for CNLDO: the highest pooled success rate occurred in infants aged 0–6 months (90.67%, I² = 81%, p < 0.01), with procedures under general anesthesia achieving 95.42% (I² = 50%; p = 0.11) efficacy. Success rates remained favorable in the 6–12 month group (85.18%, I² = 86%, p < 0.01 overall; 89.60% with general anesthesia) but declined progressively thereafter (82.34%, I² = 78%, p < 0.01 at 12–24 months). While a modest rebound occurred in the 24–48 month group (85.33%, I² = 69%, p < 0.01), the oldest cohort (48+ months) demonstrated markedly reduced efficacy (63.47%, I² = 66%, p = 0.05), despite exclusive use of general anesthesia. Conclusion: Primary probing yields the most favorable outcomes when conducted before 12 months of age, particularly under general anesthesia. Nonetheless, the overall certainty of evidence is low—mainly due to variability across studies—which should be taken into account in clinical decision-making.

Introduction: This study aimed to develop a method for predicting the risk of developing macular degeneration in the early stages by facilitating prompt intervention by medical professionals. Methods: Using a cross-sectional design, 455 age-related macular degeneration (AMD) patients from Kazakhstan were recruited via random sampling. Demographic traits, familial AMD history, medical history, and eye-related characteristics were collected through a systematic questionnaire. The patient cohort comprised 169 Caucasians and 286 Asians, with 160 males and 295 females. Results: Notably, 117 individuals (25.7%) were classified as high AMD risk, 322 (70.8%) as moderate risk, and 16 (3.5%) as low risk. Additionally, eye-related findings revealed high-risk factors, including bright iris colors, increased UV exposure, and cataract surgery, alongside presbyopia and myopia. The study underscores the need for national/regional AMD risk stratification to inform monitoring and screening programs. Recognizing high-risk individuals holds paramount significance from both public health and therapeutic perspectives, offering opportunities for early detection and management to mitigate permanent vision loss. Conclusions: The findings elucidate the interplay between risk factors, shedding light on their collective impact on AMD risk. Overall, this study's predictive model and risk categorization framework have substantial implications for ophthalmological practice, enabling timely preventive measures and potentially revolutionizing AMD management.

Introduction: This study aimed to develop a method for predicting the risk of developing macular degeneration in the early stages by facilitating prompt intervention by medical professionals. Methods: Using a cross-sectional design, 455 age-related macular degeneration (AMD) patients from Kazakhstan were recruited via random sampling. Demographic traits, familial AMD history, medical history, and eye-related characteristics were collected through a systematic questionnaire. The patient cohort comprised 169 Caucasians and 286 Asians, with 160 males and 295 females. Results: Notably, 117 individuals (25.7%) were classified as high AMD risk, 322 (70.8%) as moderate risk, and 16 (3.5%) as low risk. Additionally, eye-related findings revealed high-risk factors, including bright iris colors, increased UV exposure, and cataract surgery, alongside presbyopia and myopia. The study underscores the need for national/regional AMD risk stratification to inform monitoring and screening programs. Recognizing high-risk individuals holds paramount significance from both public health and therapeutic perspectives, offering opportunities for early detection and management to mitigate permanent vision loss. Conclusions: The findings elucidate the interplay between risk factors, shedding light on their collective impact on AMD risk. Overall, this study's predictive model and risk categorization framework have substantial implications for ophthalmological practice, enabling timely preventive measures and potentially revolutionizing AMD management.

The rapid development of digital technologies has significantly transformed many areas of healthcare, including ophthalmology. Smart technologies are increasingly integrated into ophthalmic practice to improve disease detection, monitoring, and management. The present study aims to systematize contemporary smart technologies used in ophthalmology and evaluate their clinical applicability, advantages, and current limitations. The analysis demonstrates that smart technologies in ophthalmology can be broadly categorized into three principal groups: artificial intelligence–based diagnostic systems, telemedicine and mobile health solutions designed to expand access to care. Among these, AI-based image analysis tools have achieved particularly high diagnostic performance in the detection of retinal diseases and glaucoma. Teleophthalmology platforms and smartphone-based imaging technologies enable remote screening, facilitate communication between patients and specialists, and improve healthcare accessibility in geographically remote areas. In addition, novel monitoring devices, including implantable intraocular pressure sensors and wearable contact lens–based systems, allow continuous evaluation of disease-related parameters, which is especially relevant in the management of glaucoma.

Introduction. Neovascular age–related macular degeneration, diabetic macular edema, and macular edema secondary to retinal vein occlusion are leading causes of persistent central vision loss. Faricimab is the first bispecific intravitreal agent targeting both VEGF–A and Ang–2, potentially providing meaningful early anatomical and functional benefits in real–world practice. Aim. To assess the real–world effectiveness and safety of faricimab (6 mg/0.05 mL) in patients with neovascular age–related macular degeneration (nAMD), diabetic macular edema (DME), and macular edema secondary to central retinal vein occlusion (CRVO). Materials and Methods. Twelve treatment–naïve patients who had not previously received intravitreal therapy with vascular endothelial growth factor (VEGF) inhibitors were included: 4 patients in each cohort (nAMD, DME, and CRVO). All patients received four monthly intravitreal injections of faricimab (6 mg), with assessment of best–corrected visual acuity (BCVA) and central retinal thickness (CRT). Results. OCT demonstrated a reduction in the severity of macular edema in all patients across all cohorts after the loading phase. In the overall group, BCVA improved from 0.23 ± 0.22 to 0.56 ± 0.34 (p = 0.016). CRT decreased from 503 ± 129 μm to 328 ± 76 μm (p = 0.003). No serious injection–related complications were observed. Conclusion. After the loading phase, faricimab showed early signs of functional and anatomical improvement with a favorable safety profile. Key words: Wet Macular Degeneration, Macular Edema, Diabetic Retinopathy, Retinal Vein Occlusion, Intraocular Injections. Введение. Неоваскулярная возрастная макулярная дегенерация (нВМД), диабетический макулярный отек (ДМО) и макулярный отек при тромбозе вены сетчатки (ТВС) остаются частыми причинами стойкого снижения центрального зрения и требуют регулярной анти–VEGF терапии. Фарисимаб – первый биспецифический препарат, одновременно блокирующий VEGF–A и Ang–2, что может усилить и стабилизировать анатомо–функциональный ответ в реальной клинической практике. Цель. Оценить эффективность и безопасность Фарисимаба (6 мг/0,05 мл) в реальной клинической практике у пациентов с нВМД, ДМО и макулярным отеком при ТВС. Материалы и методы. В исследовании участвовали 12 пациентов, ранее не получавших интравитреальной терапии ингибиторами фактора роста сосудистого эндотелия: по 4 пациента в каждой когорте (нВМД, ДМО, ТВС). Всем выполнено четыре ежемесячные интравитреальные инъекции Фарисимаба (6 мг) с оценкой максимально корригированной остроты зрения (МКОЗ) и центральной толщины сетчатки (ЦТС). Результаты. По данным ОКТ после загрузочной фазы у всех пациентов во всех когортах отмечено уменьшение выраженности макулярного отека. В общей когорте МКОЗ увеличилась с 0,23 ± 0,22 до 0,56 ± 0,34 (p = 0,016). Центральная толщина сетчатки уменьшилась с 503 ± 129 мкм до 328 ± 76 мкм (p = 0,003). Серьезных осложнений, связанных с инъекциями, не зарегистрировано. Заключение. После загрузочной фазы Фарисимаб продемонстрировал ранние признаки функционального и анатомического улучшения при благоприятном профиле безопасности. Ключевые слова: влажная возрастная макулярная дегенерация, макулярный отек, диабетическая ретинопатия, окклюзия вен сетчатки, внутриглазные инъекции. Кіріспе. Неоваскулярлы жасқа байланысты макулярлық дегенерация, диабеттік макулярлық ісіну және торқабық венасының окклюзиясына байланысты макулярлық ісіну орталық көрудің тұрақты төмендеуінің негізгі себептерінің бірі болып табылады. Фарисимаб – VEGF–A және Ang–2–ні бір мезгілде тежейтін алғашқы биспецификалық препарат, бұл нақты клиникалық тәжірибеде айқын анатомиялық және функционалдық әсер беруі мүмкін. Мақсаты. Неоваскулярлы жасқа байланысты макулярлық дегенерациясы (нЖБМД), диабеттік макулярлық ісінуі (ДМІ) және торқабық венасының тромбозына байланысты макулярлық ісінуі (ТВТ) бар пациенттерде фарисимабтың (6 мг/0,05 мл) тиімділігі мен қауіпсіздігін бағалау. Материалдар мен әдістер. Зерттеуге бұрын тамырлық эндотелий өсу...

Glaucoma remains the leading cause of irreversible blindness and a significant public health challenge in the Republic of Kazakhstan. This study examines the epidemiological dynamics of glaucoma in the country over the last two decades, characterized by an alarming doubling of incidence rates from 59.1 to 135.5 per 100 000 population between 2000 and 2022. We conducted a systematic literature search of PubMed, Scopus and Web of Science, supplemented by a manual search of Kazakhstani medical journals, for studies published within a 10-year timeframe to assess the impact of the National Screening Program. Following PRISMA 2020 guidelines, 12 studies were selected for a qualitative, narrative synthesis (no statistical pooling was performed) from an initial 90 records. According to a national population-based screening study, the overall glaucoma prevalence among adults over 40 years of age was 2.37±0.17%, rising to 14.2% in the 71-75-year age group; other included studies reported a primary-care detection rate of only 0.29% and a 1.91-fold higher risk in women than men. While the 2011 integration of glaucoma screening into the National Mandatory Healthcare Program significantly improved active detection, a substantial proportion of patients are still diagnosed at advanced stages, which accounts for a 3.7-fold increase in related disability over ten years. We propose, as a hypothesis to be tested rather than a finding of this review, that the current reliance on tonometry-based screening at the primary care level creates a “diagnostic shadow”, particularly failing to capture normal-tension glaucoma cases. Similar to shifts observed in national screening for cervical and colorectal cancers, the surge in glaucoma prevalence may reflect a transition from passive to active detection. This analysis provides a conceptual framework for optimizing public health strategies in Kazakhstan by moving from reactive disability management to proactive early intervention.