Russian Pediatric Ophthalmology
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Published By Izdatelstvo Meditsina

2412-432x, 1993-1859

2021 ◽  
Vol 16 (3) ◽  
pp. 37-42
Author(s):  
A. V. Pleskova ◽  
K. V. Lugovkina ◽  
Anna Yu. Panova ◽  
A. A. Sorokin

BACKGROUND: Recklinghausens generalized neurofibromatosis (NF) is a hereditary disease characterized by the formation of benign tumors from the nervous tissue that provokes skin and bone changes of various types. Often, involvement in the pathological process and the organ of vision. The variability of eye lesions in NF-I type is known according to the clinical course, severity, and clinical forms. Gliomas and atrophy of the optic nerves, neurofibromas in the iris, sclera, conjunctiva, eyelids, less often glaucoma, buphthalmos, orbital osteodystrophy are described. RESULTS: The article describes a rare case of type I neurofibromatosis, the first clinical manifestation of congenital glaucoma. Modern complex ophthalmological examination made it possible to identify the cause and clarify the nature of the development of glaucoma. CONCLUSION: The need for an interdisciplinary approach to the diagnosis, dispensary observation, and treatment of NF-I is emphasized.


2021 ◽  
Vol 16 (3) ◽  
pp. 27-35
Author(s):  
E. P. Tarutta ◽  
N. A. Tarasova ◽  
E. N. Iomdina ◽  
S. V. Milash ◽  
G. A. Markosyan

AIM: The study aims to compare the results of objective parameters such as autorefractometers of the open field Grand Seiko and closed field TONOREF III. and the subjective parameters such as the positive of relative accommodation (PRA) and the amplitude of accommodation (AA). MATERIAL AND METHODS: 30 children (60 eyes) with low and moderate myopia (on average -2.96 0.17 D) aged from 8 to 12 years (on average 10.04 0.24 years) were examined. Subjective (PRA, AA) and objective parameters of binocular adaptation (BAO) and monocular adaptation (MAO) response on the Grand Seiko Binocular Open Field Autorefkeratometer WR - 5500K (Japan) and the AA on the automatic refractokeratotonometer pakhimetre TONOREF III (Nidek, Japan) were determined. RESULTS: The average of BAO and MAO at 33 cm was -1.93 0.04 D and 1.86 0.05 D, respectively. The average PRA was 1.5 0.16 D. The objectively measured average AA was 5.25 0.4 D. The average minimum AA value was -2.86 0.16 D, and the average maximum value was 8.11 0.46 D. The subjective AA on the Iksar device was on average 4.17 0.43 D; Amin, on average -3.77 0.26 D; Amax, on average was -7.94 0.59 D. CONCLUSION: The objective and subjective measurements of AA produced comparable results. BAO and MAO reflected other characteristics of accommodation, different from its amplitude, and characterized the adequacy of the accommodation response to a specific accommodation task. The advantage of objective accommodation is that it is independent of the patients responses and intellectual level.


2021 ◽  
Vol 16 (3) ◽  
pp. 11-18
Author(s):  
T. B Kruglova ◽  
Tatyana N. Kiseleva ◽  
L. A. Katargina ◽  
N. S. Egiyan ◽  
A. S. Mamykina ◽  
...  

BACKGROUND: Relevant keratometric and biometric indicators are necessary for intraocular lens (IOL) power calculation, which is difficult to verify in young children. AIM: Evaluation of the accuracy of various ultrasound methods and optical biometry for axial length measurement in young children with congenital cataracts. MATERIAL AND METHODS: Forty-six children (74 eyes) with congenital cataracts (43 eyes) and pseudophakia (31 eyes) at the age of 6 months to 4 years were examined. Various methods measured the axial length: ultrasound A-scan under general anesthesia by US-4000, ultrasound B-scan without general anesthesia by Voluson E8, and optical biometry by AL-Scan in cases of transparent optics. RESULTS: The greater axial length difference was observed between A-scan and optical biometry (less by 0,78 mm) than between B-scan and optical biometry (more by 0,27 mm). The median axial length difference between A-scan and B-scan was equal for infants and young children with congenital cataracts (0,525 mm and 0,535 mm, respectively). CONCLUSION: Axial length should be measured by different methods in young children with their further comparison to obtaining more accurate biometric indicators for IOL power calculation. The decrease of 12 mm in axial length, which occurs during the A-scan, can lead to errors in the IOL calculation of 36 diopters and unplanned refraction in the long-term period.


2021 ◽  
Vol 16 (3) ◽  
pp. 5-10
Author(s):  
M. A. Kariakin ◽  
E. A. Stepanova ◽  
S. A. Korotkikh ◽  
N. S. Timofeeva ◽  
S. I. Surtaev

AIM: To conduct a retrospective study of the application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of prematurity in Ural State children`s ophthalmological center at State Autonomic Health Institution of the Sverdlovsk Region Multiprofile Clinical Medical Center BONUM in Yekaterinburg. MATERIAL AND METHODS: The study included 17 patients (33 eyes). The gestation age was from 23 to 30 weeks (mean: 26.51.7 weeks), birth weight was from 600 to 1850 g (mean: 867229 g). 8 patients (47%) had APROP, and 9 patients (53%) had ROP stage III, type 1, plus disease. Laser coagulation of the avascular areas of the retina as the start in ROP therapy was performed in three patients with APROP (4 eyes, 12.1%). Intravitreal injection of the anti-VEGF ranibizumab was performed in 17 patients (33 eyes), including patients with previous laser coagulation. The age of the patients at the time of injection was from 7.7 to 15.6 weeks (10.51.9 weeks), PCA from 32.3 to 39.6 weeks (37.01.8 weeks). Patients with stage IVa ROP (5 patients, 6 eyes) underwent 25G or 27G lens sparing vitrectomy. RESULTS: As a result of the complex treatment of ROP, the following results were obtained: complete regression in 13 patients (28 eyes, 84.8%). Partial regression in two patients (2 eyes, 6.1%). ROP progression to stage V in two patients (3 eyes, 9.1%). CONCLUSION: Complex treatment of severe stages of active ROP with laser treatment, IVI injections, ranibizumab, and vitrectomy made it possible to preserve vision in 90.9% of patients.


2021 ◽  
Vol 16 (3) ◽  
pp. 43-48
Author(s):  
L. A. Kovaleva

Part I of the article presents a review of publications highlighting current exogenous and endogenous risk factors contributing to the occurrence of bacterial corneal ulcers, laboratory diagnostic methods, clinical differential diagnostic features of bacterial corneal ulcers. A wide variety of objective symptoms characterizes the clinical picture of bacterial corneal ulcers. Still, objective differential diagnostic signs make it possible with a high degree of probability to assume the etiology of the disease during the first biomicroscopy and immediately begin etiotropic therapy, on the timing of which the outcome of the disease depends. Standard laboratory examination of patients with bacterial corneal ulcers includes the bacterioscopic and cultural examination of the contents of the conjunctival sac. However, the absence of etiotropic therapy while waiting for the results of microbiological research methods, which takes from 3 to 7 days, contributes to the rapid progression of the disease, the development of endophthalmitis, and corneal perforation, up to the loss of an eye in children. In this regard, treatment must be started immediately. Therefore, the choice of a drug is determined not only by the causative agent, proven laboratory but, first of all, based on clinical differential diagnostic signs of the disease. The traditional, undeniable approach to the conservative treatment of bacterial corneal ulcers is conventional etiotropic therapy using local and systemic antibacterial drugs. In addition, timely intensive specific drug therapy prevents the destruction of all layers of the cornea, and the use of metabolic drugs that improve regeneration and trophism promotes epithelialization of corneal ulcers. Attention should be given to the necessity and validity of the choice of antibacterial drugs for various etiological forms of bacterial corneal ulcers in children. An individual approach is a basis for effective antibiotic therapy in pediatric ophthalmology. The article presents an up-to-date review of publications and modern algorithms for treating bacterial corneal ulcers in children, the main causative agents of which are: Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Neisseria gonorrhoeae.


2021 ◽  
Vol 16 (3) ◽  
pp. 19-26
Author(s):  
A. Y. Panova ◽  
A. S. Petrova ◽  
S. A. Trusova ◽  
O. A. Shevernaya

BACKGROUND: Ranibizumab is widely used in retinopathy of prematurity. Therefore, it is necessary to evaluate the effectiveness, the risk of complications, and recurrence of the disease by antiangiogenic therapy. AIM: To demonstrate the experience of using anti-VEGF drugs in the Moscow Regional Perinatal Center and the effectiveness of different approaches to retinopathy of prematurity (ROP) treatment in the central retinal zone. MATERIAL AND METHODS: The case histories of 17 deeply premature infants with threshold ROP stages and localization in the posterior pole were retrospectively analyzed. Children were treated with intravitreal VEGF inhibitor (total 9 children), 5 children underwent laser coagulation of the retina, and 3 children received combined treatment (laser and intravitreal administration of a VEGF inhibitor). RESULTS: The average age of development of threshold stages was 35.2 weeks (range: 30.539 weeks) in our study. The frequency of promising outcomes after using anti-VEGF drugs alone or in conjunction with peripheral laser treatment was 100%. In comparison, the only laser treatment generated a promising result in 70% of the eyes. However, ROP relapses after anti-VEGF therapy developed at 37, 43, 44,5 weeks. In addition, 1 out of 9 children developed a recurrence of ROP and required laser treatment 7 weeks after using anti-VEGF. CONCLUSION: The use of anti-VEGF therapy is an effective method for the treatment of ROP of the posterior pole. However, there is the ambiguity of the available recommendations on the further management of children. Therefore, it is necessary to monitor the children who have received antiangiogenic therapy for as long as possible.


2021 ◽  
Vol 16 (2) ◽  
pp. 31-39
Author(s):  
Elvira I. Saidasheva ◽  
Svetlana V. Buianovskaia

The article is focused on the peculiarities of the clinical course of separate forms of neonatal conjunctivitis, depending on the etiological factor. It was found that more often the disease refers to nosocomial eye infection and bacterial nature. We performed the bacteriological analysis of the contents of the conjunctival cavity of 50 newborn patients being treated in the neonatal department. Our analysis indicated the leading role of gram-positive bacteria Staph. epidermidis (59.7%) and Staph. aureus (21.7%) in the development of the inflammatory process. The share of other types of pathogens, including gram-negative minor and various pathogens, is from 0.54% to 3.2%. The cause of nosocomial infection is considered to be the pathogen that circulates in the department and acquires the features of a hospital strain. These are consistent with the results of similar studies conducted by both domestic and foreign clinicians, which are also presented in the article. Particular attention is paid to the causative agents of intrauterine infections that are dangerous for the anterior section: gonococcus, chlamydia, herpes simplex, etc. These agents often cause serious diseases in newborns (gonoblenorrhea, ophthalmic chlamydiosis, and ophthalmic herpes), in which the cornea and vision are often affected. The article highlights the measures of primary prevention of intrapartum infection of the ocular surface in newborns, adopted in Russia. The paper presents modern approaches to selecting drugs for local antibacterial therapy of neonatal conjunctivitis, considering age restrictions for their use. Methods of laboratory diagnostics and their validity for the etiology of conjunctivitis have been described in detail. For example, the bacteriological method (inoculations in various culture media) is considered a reference (specificity 100%). The culture medium can be used to isolate bacteria, chlamydia, and mycoplasma, which allows getting clear results even with a minimal amount of microflora


2021 ◽  
Vol 16 (2) ◽  
pp. 53-60
Author(s):  
Aleksandr V. Apaev

The article provides information on the prevalence of nystagmus in the Russian Federation and the world. However, the lack of standards for data collection and the very understanding of the definition of optical nystagmus is the reason for the variation in prevalence values in different sources. Additionally, the article presents various classifications of nystagmus. Currently, there are many different classifications, and the most commonly used examples are given. The classification of eye movement disorders and strabismus, adopted by the working group in 2001 (Classification of Eye Movement Abnormalities and Strabismus CEMAS), is used worldwide. In our country, the most popular was the classification proposed by E.S. Avetisov (2001). Various sources have suggested quite contradictory data on the nature of the onset and the mechanism of development of nystagmus. Recently, the issues related to the pathogenesis of nystagmus have been revised. The theories that existed at the end of the last century were not substantiated in modern works. The pathogenesis of optic nystagmus remains less studied due to its complexity and ambiguity. The investigations continue to find the relationship between the pathology of the central nervous system and functional disorders of visual functions. The question of the relationship between visual acuity and nystagmus remains unclear. Does a decrease in vision cause nystagmus? How do oscillatory movements in nystagmus affect visual functions? This article encompasses the main areas of this issue. However, despite a significant step in understanding the causes of the development of nystagmus, this pathology remains insufficiently studied. This prompts many researchers and practicing doctors to study its pathogenesis further


2021 ◽  
Vol 16 (2) ◽  
pp. 5-13
Author(s):  
Lyudmila A. Katargina ◽  
Natal’ya B. Chesnokova ◽  
Natal’ya V. Balatskaya ◽  
Natal’ya Anatolievna Osipova ◽  
Anna Yurievna Panova

Background: The efficiency of treatment and prevention of retinopathy of prematurity (ROP) has improved. In addition, the development of a disease screening system to reduce the incidence of disability resulting from this pathology is important. Aim: This study aimed to determine new laboratory criteria for screening and predicting the ROP course through in-depth investigation of the molecules participating in the pathogenesis of ROP. Material and methods: A comprehensive clinical and experimental study was performed to assess the local and systemic levels of 49 cytokines with various biological effects, four monoamines, and angiotensin-II (AT-II) at different stages of the pathological process. In the clinical analysis, 165 preterm infants at risk of ROP development were examined. For the experimental part, the disease course of 145 Wistar infant rats in the developed model of experimental ROP was analyzed. Results: Among cytokines, the seven most promising potential laboratory markers of ROP development and adverse course were as follows: MCP1 95 pg/mL, IGF-II 140 pg/mL, TGFbeta1 18000 pg/mL, and IGF-I 24 pg/mL in the blood serum of preterm infants before the first signs of ROP and VEGF-A 108 pg/mL, TGF-beta2 100 pg/mL, and PDGF-BB 1800 pg/mL at ROP manifestation. Among monoamines, serotonin (17.0 pg/mL) and L-DOPA indicated their prognostic value in the clinical and experimental settings. Moreover, a possible prognostic role of AT-II was found. Conclusion: In this study, methods to improve the ROP screening system are outlined, but further work is necessary to assess the possibility of implementing the results in clinical practice


2021 ◽  
Vol 16 (2) ◽  
pp. 23-30
Author(s):  
Ludmila Kovaleva

Bacterial corneal ulcer is the second most common complication of herpetic ulcer, but it is the most severe complication and has the highest progression rate. The main causative agents of bacterial corneal ulcers are Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Neisseria gonorrhoeae. The frequency of the detection of corneal ulcers caused by gram-negative Pseudomonas aeruginosa has increased, which is characterized by a lightning-fast course and a high frequency of complications and adverse outcomes. Gonococcal corneal ulcer caused by Neisseria gonorrhoeae is less common in pediatric patients than in adult patients, but it has the most aggressive disease course, which does not change with age. Bacterial corneal ulcers are one of the main causes of corneal blindness and can lead to endophthalmitis, corneal perforation, and eye loss within a short time. Clinical differential diagnostic signs allow us to assume, with a high degree of probability, the etiology at the first biomicroscopy and immediately begin etiotropic therapy, which is crucial for the outcomes of bacterial corneal ulcer. The standard laboratory examination of patients with bacterial corneal ulcer includes bacterioscopic and culture examinations of the contents of the conjunctival sac. This paper presents an up-to-date review of publications, clinical features, differential diagnostic criteria, laboratory diagnostic methods of bacterial corneal ulcers in pediatric patients


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