Changes in the organ of vision in children and adults with confirmed COVID-19 and anti-epidemic measures

The COVID-19 pandemic revealed several aspects of the problems directly related to the Ophthalmologists: damage to the eyes of patients with the SARS-CoV-2 virus; organization of medical work in a pandemic, including in a medical department redesigned to treat patients infected with SARS-CoV-2; side effects of personal protective equipment usage and anti-epidemic measures aimed to protect the organ of vision. Ocular manifestations were noted in 15–23% of children and 4–31% of adults with COVID-19. They were usually limited to acute conjunctivitis with «clear» discharge, hyperemia, edema and folliculosis of the conjunctiva, which reduced in 7–14 days without any treatment or on symptomatic therapy. The presence of SARS-CoV-2 in the tear and epithelium of the conjunctiva does not always correlated with the presence and severity of conjunctivitis and therefore had no clinical significance. There were also other problems associated with anti-epidemic measures (dry eye syndrome when wearing personal protective equipment, computer visual syndrome, etc.), which also requires attention of Ophthalmologists. Key words: COVID-19, SARS-CoV-2, ocular manifestations in children and adults.

Preterm labor – an unresolved problem of the XXI century

The article discusses one of the most significant problems in the modern obstetric practice – preterm labor (PL). The upward trend in PL worldwide is related to an increase number of multiple pregnancies due to in vitro fertilization (IVF). PL is one of the main causes of early neonatal mortality and disability in children, also increases the survival rate of newborns with extremely low birth weight, and therefore it significantly changes the structure of surviving premature infants' morbidity. The greatest threat is represented by the «threshold» stages of the disease, with the development of which the process becomes almost irreversible and requires immediate treatment. To improve the perinatal outcomes of PL, the authors draw attention to two problems: first of them – to understand the mechanism of PL, the second one-to work out tactics that allow to carry out measures that can delay, prevent the distress syndrome, and improve fetal condition at any stage of the disease. Key words: preterm birth, in vitro fertilization, quality of life, retinopathy of prematurity.

Limbal conjunctival approaches to extraocular muscles in the surgical treatment of previously operated strabismus

Purpose. Тo analyze clinical efficacy of the surgical treatment of previously operated strabismus using limbal incisions which are lengthening the conjunctiva and Tenon's capsule. Material and methods. The study included 440 patients (440 eyes) with previously operated strabismus at the age of 4 to 68 years old. The main group included 240 patients (240 eyes) who underwent strabismus surgery by limbal approach; the control group included 200 patients (200 eyes) who underwent surgery by paralimbal conjunctival approach. Horizontal strabismus occurred in 146 patients (60,8%) in the main group and in 158 (79%) in the control group. Horizontal strabismus in combination with vertical strabismus was found in 94 patients (39.2%) in the main group and in 42 patients (21%) in the control group respectively. The following approaches were applied: Y-shaped limbal approach, T-shaped incision of the conjunctiva, lower limbal peritomy, circular limbal approach with an additional horizontal incision towards the muscle being strengthened. Results. Good cosmetic result in the main group was achieved in 94.7% of cases, in the control group in 87% of cases, р<0.001. Re-surgery in the long term period was required for 39 patients (19.5%) in the control group and 14 patients (7%) in the main group, р<0.001. Conclusion. Limbal approaches performed to lengthening the conjunctiva and Tenon's capsule on the side of the weakened muscle and shortening on the side of the muscle being strengthened, are enhancing the effect of recession and resection, thereby contributing to the achievement of the state of orthotropy in 83% and have a good cosmetic result in 94.67% of cases. Key words: limbal conjunctival approaches, limbal conjunctival incisions, strabismus, children.

A rare case of oculocutaneous melanosis (nevus of Ota) at Ophthalmologist's appointment

A rare clinical case of nevus of Ota in a 6-year-old child is described. The clinical picture and diagnostic methods used in this case are reflected. On the example of the patients presented in this article, differential diagnosis with alkaptonuria is fully described. Given the risk of transition to skin melanoma and ocular melanoma, patients with nevus of Ota should be observed by Dermatologist and Ophthalmologist annually. Such patients should also strictly avoid exposition to any ultraviolet radiation and exclude possible risk factors traumatizing the nevus. Key words: nevus, Ota nevus, alkaptonuria, skin melanoma, eye melanoma.

Transpupillary laser thermotherapy for retinoblastoma

The review article presents the literature data concerning the history of the use of thermotherapy in the treatment of intraocular tumors, in particular, retinoblastoma (Rb). The article describes the historical aspects of the use of transpupillary thermotherapy (TTT) and the possibility of using this method in the treatment of RB nowadays. The analysis of Russian and foreign publications on the main parameters of laser radiation and the multiplicity of TTT was carried out. The efficacy of TTT as an independent method of Rb treatment has been demonstrated. The frequency of the main complications of TTT in Rb is presented. Key words: ophthalmology, retinoblastoma, transpupillary thermotherapy, laser treatment, pediatric oncology.

Structure of ophthalmic pathology according to S. Fyodorov Eye Microsurgery Federal State Institution and development of innovative technologies

The article discusses the structure of ophthalmic pathology. These results are based on the analysis of statistical data of a large number of patients of the S. Fyodorov Eye Microsurgery Federal State Institution in 2019 (year before COVID-19 pandemic). In 2019 – 565988 patients were registered in medical database of our institution for the first time. The distribution of ophthalmic pathology among these patients was as follows. Cataract – 25.0%, including complicated cataract 15.9 %. Glaucoma – 3.1%; Vitreoretinal pathology – 8.2%; Diabetes – 2.9%; Oculoplastic pathology – 2.7%; Oncology – 1.1%; Eye diseases in children – 12.9%; Refractive errors – 17.2%; Diseases of the eye fundus – 12.6 %; Corneal pathology – 2.2%; Inflammatory diseases – 10.3%; Other diseases – 1.8 %. The article carefully describes the innovative technologies and the main trends that determine the overall development of such areas of ophthalmic surgery as: cataract surgery, glaucoma, corneal surgery, vitreoretinal surgery, laser refractive surgery, laser surgery of the retina and vitreous body, surgical manipulations in children, oculoplasty, ophthalmooncology. Key words: structure of ophthalmic pathology, innovative technologies of ophthalmic surgery, main trends of ophthalmic surgery.

Corneal collagen crosslinking in a child with keratoconus

This clinical case describes medical history of the patient who came to the clinic with complaints of progressive decrease in visual acuity and intolerance of spectacle correction. In the following article all methods of diagnostic are fully described. We are also mentioning and discuss aspects of modern methods of diagnostic and treatment of keratoconus in children such as corneal collagen crosslinking. Key words: keratoconus, keratoconus in children, corneal collagen crosslinking.

Smoking of Parents as a Factor of Visual Impairment in Schoolchildren in Baku

Purpose. To study the number of medical appeals and the incidence of school-age children in Baku, exposed to passive smoking in their families. Material and methods. Schoolchildren were given 5000 questionnaires; the response was 2363 questionnaires (39.4±0.6%). The collected questionnaires of schoolchildren contained the answers of a total of 3895 parents, of which 1885 were fathers and 2010 were mothers. All schoolchildren were divided into 2 groups: 818 schoolchildren whose parents were tobacco-dependent and 1545 schoolchildren whose parents were tobacco-dependent. Depending on the degree of tobacco dependence of parents, 818 schoolchildren were divided into groups: group 1 – non-systematic smoking of parents (about 5 cigarettes a day), tobacco dependence is weak, there are no visible effects on health – 204 schoolchildren; 2nd group – habitual smoking of parents (5–15 cigarettes per day), moderate tobacco dependence, a number of negative effects on health are manifested – 252 schoolchildren; Group 3 – parents' addiction (more than 15 cigarettes a day), severe tobacco dependence, pronounced dysfunctions of various organs are manifested – 362 schoolchildren. We analyzed the outpatient medical records of children in the district children's polyclinics and determined their medical appealss and the degree of morbidity. Results. It was found that despite the widespread anti-tobacco campaign, in 34.6±1.0% of families in Baku, schoolchildren continue to be exposed to the effects of secondhand smoke, which has a detrimental effect on their eye health. The medical appeals of schoolchildren to children's polyclinics increase by 1.95 times and the level of their morbidity increases by 1.35 times, and in families whose parents smoke more than 15.0 cigarettes/ day it reaches 79.8±2.5%. Conclusion. A wide accessible educational campaign among parents is needed, the main argument of which should be the harmful effects of secondhand smoke on the health of the eyes of children. Key words: passive smoking, schoolchildren, health, eye care, vision protection.

Microcirculatory Changes in the Retina in Patient with COVID-19

A clinical case of observation of a patient who had branch retinal vein occlusion with the development of macular edema, against the background of a moderate-severe course of COVID-19, was considered. The clinical picture and diagnostic methods necessary for the diagnosis are described. Some aspects of pathological changes in the organ of sight in COVID-19 are discussed. Key words: COVID-19, branch retinal vein occlusion, macular edema, renin-angiotensin-aldosterone system.

A case of congenital diffuse lipomatosis in ophthalmic practice

A clinical case of a childhood form of diffuse lipomatosis is considered. The clinical picture and diagnostic methods necessary for the establishment of a clinical diagnosis are reflected. When observing patients with diffuse lipomatosis, it is required to involve specialists of various specialties and conduct thorough diagnostic measures to verify the clinical diagnosis and select the appropriate treatment methods. Key words: congenital malformations of the organ of vision, germ layers, mesenchyme, connective tissue, lipomatosis.