Vol 7, No 2 (2012)

Articles
THE EFFECTIVENESS OF THE MAIN STAGES OF REMEDIAL MEASURES DESIGNED TO MANAGE CONGENITAL STENOSIS OF THE NASOLACRIMAL CANAL IN THE CHILDREN
Brzhesky V.V., Chistyakova M.N., Kalinina I.V.
Abstract
The authors undertook the analysis of the effectiveness and the causes behind the failure of various stepwise remedial measures provided for the children presenting with atresia of the nasolacrimal canal. The study included 285 children at the age varying from 2 weeks to 15 years (346 eyes). 235 or 85.6% patients (296 eyes) suffered complications in the form of neonatal dacryocystitis. Lacrimation was completely recovered after probing and bougienage of the nasolacrimal canal (in 93.6% and 45.7% of the cases respectively), after the subsequent bougienage and Ritleng lacrimal intubation with the use of a silicone filament (58.3%), and after dacryocystorhinostomy by the modified method of Taumi (77.8%). All these interventions should be performed for the patients exhibiting the clinical signs of dacryocystitis (taking into consideration their age) in a sequential fashion, after each preceding procedure failed to yield the desired effect. Instillation of antibacterial preparations with a broad spectrum of actions is indicated during the preparation to each next surgical intervention.
Russian Pediatric Ophthalmology. 2012;7(2):4-7
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THE MODERN APPROACH TO THE VISUAL EXAMINATION OF THE ANGLE OF THE ANTERIOR EYE CHAMBER IN THE CHILDREN — IRIDOCORNEAL GONIOGRAPHY
Brusakova E.V., Ershova R.V., Panchishena V.M., Sokolov V.O., Fomina N.V.
Abstract
A method for the visual examination of the angle of the anterior eye chamber (iridocorneal goniography) in the children with the help of a broad-band digital pediatric retinal RetCam camera is described. The results of the examination of 120 children (240 eyes) at the age varying from the neonatal period to 18 years are presented . The diagnostic value of the method is estimated. The new data obtained extend the possibilities of the visual examination of the angle of the anterior eye chamber in the children. It is concluded that iridocorneal goniography of the eyes may be recommended for the wide application in pediatric ophthalmology.
Russian Pediatric Ophthalmology. 2012;7(2):7-11
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THE INFLUENCE OF INHIBITORS OF TUMOUR NECROSIS FACTOR-ALPHA ON THE CLINICAL COURSE OF RHEUMATOID UVEITIS AND DYNAMICS OF IMMUNOLOGICAL CHARACTERISTICS
Katargina L.A., Denisova E.V., Slepova O.S., Lyubimova N.V., Starikova A.V., Osipova N.A., Petrovskaya M.S.
Abstract
The present study included 34 children aged from 4 to 16 years presenting with uveitis associated with rheumatoid diseases, such as juvenile idiopathic arthritis (n = 32) and Behcet’s disease (n = 2). The levels of tumour necrosis factor-alpha (TNF-alpha) in blood sera (BS) and lacrimal fluid (LF) were measured in the patients differing in the activity of the inflammatory processes in the eyes within a period from 4 days to 2 years 9 months after the onset of the treatment with TNF-alpha inhibitors (infliximab and adalimumab). A total of 57 BS samples and 27 LF samples taken from the affected eyes were available for the analysis. Active uveitis was diagnosed in 76.9% of the 26 cases in the absence of TNF-alpha in BS and in 35.5% of the 31 cases at the cytokine levels from 2 to 21 pg/ml (i.e. the two-fold difference, p < 0.01). The analogous results were obtained by the measurement of TNF-alpha in LF. Its absence in LF was associated with the inflammatory process in 84.6% of the 13 cases and 14.3% of the 14 cases at the cytokine level from 2 to 10 pg/ml (p < 0.001). Remission of uveitis was most frequently achieved in the patients having low TNF-alpha concentrations in both fluids. It means that remission of uveitis may be achieved and maintained by the reduction of TNF-alpha concentrations in BP and LF to an optimal minimal level; there is no need to completely suppress its secretion. It is concluded that immunological monitoring facilitates the correction of the treatment and the improvement of the outcome of the disease.
Russian Pediatric Ophthalmology. 2012;7(2):11-14
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THE ROLE OF THE COMPROMISED CYTOKINE STATUS IN PATHOGENESIS OF LATE VITREORETINAL COMPLICATIONS OF RETINOPATHY IN PREMATURE INFANTS
Katargina L.A., Slepova O.S., Belova M.V., Andryushin A.E.
Abstract
A total of 44 patients at the age from 5 months to 22 years presenting with cicatrical and regressive stages of grade I-V retinopathy of prematurity (ROP) were available for the examination. The levels of 9 cytokines and growth factors were measured in their sera with the use of the flow cytofuorimetric technique and multiplex analysis. The patients were allocated to four groups dpending on the presence and character of late vitreoretinal complications of ROP. It was shown that the deficiency of tumour necrosis factor beta-1 of all the parameters studied responsible for the development of dystrophy and retinal detachment constitutes the most important defect in the immunoregulatory system. The enhanced systemic production of VEGF and proinflammatory cytokines was the aggravating factor.
Russian Pediatric Ophthalmology. 2012;7(2):14-17
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DRY EYE SYNDROME ASSOCIATED WITH ENDOGENOUS UVEITIS IN THE CHILDREN
Katargina L.A., Shestova Y.P., Denisova E.V.
Abstract
A total of 47 children with uveitis of different localization and etiology were available for the estimation of overall lacrimation and stability of the precorneal lacrimal film. The study demonstrated a high frequency of dry eye syndrome (DES) diagnosed in 85% of the patients suffering the moderately or strongly impaired lacrimation and stability of the precorneal lacrimal film (in 46% and 28% of the cases respectively). The multi-factor character of dry eye syndrome was documented. Its development was shown to be related to the frequency of relapses of uveitis, the presence of a systemic rheumatoid disease, local anti-inflammatory and hypotensive therapy, systemic immunosuppressive treatment, and/or surgical interventions on the anterior parts of the eyes. DES was shown to be associated with the dystrophic changes in the cornea. The necessity of early diagnostics of dry eye syndrome in the patients presenting with uveitis and of prescription of tear replacement therapy is substantiated.
Russian Pediatric Ophthalmology. 2012;7(2):17-20
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THE STATE OF THE VISUAL ANALYZER IN THE CHILDREN WITH RETINOPATHY OF PREMATURITY
Kogoleva L.V., Katargina L.A., Krivosheev A.A., Mazanova E.V.
Abstract
A high frequency of pathological changes in the visual analyzer was documented in the children with retinopathy of prematurity (RP) depending on the severity of the disease. They occurred in 38.6% of the patients with grade 0-1 RP and in up to 100% of those with grade 4 RP. In the majority of the patients with minimal residual changes associated with retinopathy of prematurity, the disturbances of evoked visual potentials (EVP) appear to be caused by the pathological processes in the visual pathways and the upper parts of the visual analyzer. As the severity of the disease increases, the development of vision becomes increasingly influenced not only by the concomitant pathology of the optic tract but also by the consequences of preceding RP. The combined application of the methods used for multichannel recording of EVP and HRT substantially extends the possibilities for the estimation of the character and the level of injuries to the visual pathways, the prediction of formation of visual functions, and the choice of the therapeutic strategy for the management of the patients presenting with retinopathy of prematurity.
Russian Pediatric Ophthalmology. 2012;7(2):20-25
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FEMALE ALCOHOLISM AND EYE PATHOLOGY IN THE CHILDREN PRESENTING WITH FETAL ALCOHOL SYNDROME
Paramei O.V.
Abstract
The data concerning the current state of the problem of female alcoholism, the incidence and prevalence of fetal alcohol syndrome (FAS) are overviewed and analysed. The state of the organ of vision was estimated in 22 schoolchildren presenting with fetal alcohol syndrome. The study has demonstrated the high frequency of pathological changes in the eyelids and optic nerve hypoplasia (in 63.6% and 40.9% of the patients respectively).
Russian Pediatric Ophthalmology. 2012;7(2):25-28
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THE ROLE OF INFECTIOUS FACTORS IN THE DEVELOPMENT OF PROLIFERATIVE SYNDROME IN THE CHILDREN PRESENTING WITH ENDOGENOUS UVEITIS
Petrovskaya M.S., Denisova E.V., Slepova O.S., Katargina L.A.
Abstract
The present study included a total of 89 children presenting with uveitis of different localization and etiology. The objective of this work was to elucidate the relationship between the development of proliferative syndrome and infectious processes as well as to determine the serological markers of activation of ophthalmotropic infections (caused by type 1 and 2 herpes simplex viruses, cytomegalovirus, and Epstein-Barr virus, causative agents of toxoplasmosis, tuberculosis, toxocariasis, chlamydiasis, ureplasmosis, and mycoplasmosis). The patients with proliferative complications were shown to exhibit the highest frequency of infection with cytomegalovirus and Epstein-Barr virus in conjunction with reactivation of chronic infection with herpes simplex viruses. This finding suggests the possible influence of herpetic infections on the development of prolferative complications in the children with uveitis.
Russian Pediatric Ophthalmology. 2012;7(2):28-31
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THE MODIFIED METHOD FOR THE SURGICAL TREATMENT OF RECURRENT DACRYOCYSTITIS IN THE CHILDREN
Rykov S.A., Barinov Y.V., Barinova A.A.
Abstract
The objective of the present study was to estimate the efficacy of the modified method for the surgical treatment of recurrent dacryocystitis in the children by probing the nasolacrimal canal with its subsequent filling with a mixture of an antibiotic-containing viscoelastic solution for temporary intubation. A total of 1000 children aged from 3 months to 5 years presenting with recurrent dacryocystitis were treated by this method. As a result, normal lacrimation was recovered in 77% of the children under the age of 3 years. This non-invasive method is easy to operate and does not require the use of any additional special instruments.
Russian Pediatric Ophthalmology. 2012;7(2):31-34
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BIOCHEMICAL CHARACTERISTICS OF THE UPPER EYELID TISSUES IN THE CHILDREN WITH CONGENITAL PTOSIS
Filatova I.A., Iomdina E.N., Sitnikova D.N.
Abstract
The objective of the present work was to study biomechanical characteristics of the upper eyelid tissues (skin, levator and circular muscles) in 33 children at the age varying from 3 to 17 years presenting with congenital ptosis. Analysis of the results of mechanical testing of 62 tissue samples obtained in the course of reconstructive treatment of congenital ptosis has demonstrated their specific stress-strain properties related to the patients’ age and the severity of the disease. The most conspicuous biomechanical abnormalities associated with the severe form of congenital ptosis were found in the levator muscle. They correlated with the changes in the biomechanical properties of the upper eyelid skin. The changes in the circular muscle of the children with congenital ptosis were less apparent compared with those in the levator muscle and the upper eyelid skin.
Russian Pediatric Ophthalmology. 2012;7(2):34-37
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THE PRINCIPLES OF ORGANIZATION OF OPHTHALMOLOGICAL CARE IN SANKT-PETERBURG
Saidasheva E.I., Fomina N.V., Baranov A.V., Korlyakova M.N.
Abstract
Ophthalmological care of newborn infants is a constituent component of the comprehensive neonatal health care program. The adequate organization of its delivery is an important reserve for the reduction of the frequency and severity of visual impairment since the early age leading to children’s disablement. The results of analysis of the current state and drawbacks of the organization of the ophthalmological care in Sankt-Peterburg are presented. It is concluded that the existing comprehensive stepwise system for the provision of diagnostic, therapeutic, and rehabilitative aid to the children with ophthalmological problems starting from the very first days of their life is sufficiently efficacious.
Russian Pediatric Ophthalmology. 2012;7(2):39-43
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MORPHOLOGICAL STUDIES OF THE TISSUE STRUCTURE OF THE EYE AND ITS APPENDAGES UNDER CONDITIONS OF ENHANCED REPETITION FREQUENCY OF THE INFRASOUND TREATMENT PROCEDURE
Aminulla A.A., Filatov V.V., Fedorov A.A., Ul’shina L.V.
Abstract
This paper is devoted to the study of the influence of the repetition frequency on the tissue structures of the eye. The experiments were performed on 8 Chinchilla gray rabbits (16 eyes). The data obtained show that an increase in the repetition frequency of infrasound treatment from one to 3 sessions during a day does not lead to an irreversible damage of the eyeball tissues and structure.
Russian Pediatric Ophthalmology. 2012;7(2):43-46
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THE DEVELOPMENT OF THE RATIONAL SCHEME FOR THE APPLICATION OF DERINAT EYE DROPS, 0.25%, IN THE COMBINED TREATMENT OF EXPERIMENTAL OPHTHALMOHERPES
Stirmanova E.R., Shchipanova A.I., Katargina L.A.
Abstract
The authors report the results of the experimental evaluation of the efficacy of a new parmaceutical dosage form of derinat eye drops. The study was carried out using the experimental rabbit model of ophthalmoherpes. In the first series of experiments, the therapeutic efficacy of derinat eye drops, 0.25%, was compared with that of 3% zovirax eye ointment. It was shown that derinat produced a well-apparent therapeutic effect comparable with that of zovirax. The clinical efficacy of combined therapy with derinat and zovirax with different intervals between the applications of either preparation was estimated in the 2 nd and 3d series of experiments. It is concluded that it is important to strictly comply with the prescribed intervals (2 hours) between the applications of the tested medications.
Russian Pediatric Ophthalmology. 2012;7(2):46-49
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THE ROLE OF ANGIOGENESIS IN THE DEVELOPMENT AND PROGRESSION OF DIABETIC RETINOPATHY IN THE PATIENTS WITH TYPE 2 DIABETES MELLITUS
Vorobieva I.V., Merkushenkova D.A., Estrin L.G.
Abstract
Diabetic retinopathy is known to be a leading cause of blindness in the capable of working patients with type 2 diabetes mellitus in the developed countries. The key role in pathogenesis of diabetic retinopathy, diabetic macular oedema, and proliferation of newly formed blood vessels is played by vascular endothelial growth factor. The use of anti-angiogenic therapy in combination with the laser-assisted treatment is considered to be a promising instrument for pathogenetic therapy of diabetic retinopathy.
Russian Pediatric Ophthalmology. 2012;7(2):50-51
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CLASSIFICATION (CLINICAL-SURGICAL) OF CONGENITAL CATARACT
Bobrova N.F.
Abstract
The clinical-surgical classification of congenital cataracts has been elaboratedn based on the results of the longterm (up to 25 years) examination and surgical treatment of more than 1000 newborn infants and children at the age varying between 2 weeks and 18 years (1600 eyes). The classification was theoretically validated and verified in clinical practice. The patients were allocated to the three groups based on the type of congenital cataracts: group 1 — zonular cataracts (with preserved normal anatomy of the lens and intermittent opacification of the lenticular substance), group 2 - total cataracts (with preserved normal anatomy and complete opacification of the lens), and group 3 — atypical cataracts (with altered anatomical structure, volume, and shape of the lens and its either complete or irregular opacification). Morphological features of the child’s whole body and congenital cataracts as well as the presence or absence of the accompanying eye pathology and the state of residual vision were used as the basis for the formation of the above three groups. Collectively, these features should be taken into consideration for the choice of the optimal time and the type of surgical intervention for the removal of cataracts (primary intraocular lens (IOL) implantation, preservation of the posterior capsule, etc.). The data obtained are of special importance for the prediction of the outcome of the disease and its treatment.
Russian Pediatric Ophthalmology. 2012;7(2):52-57
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THE LEVEL OF HEMOGLOBIN AND THE NUMBER OF BLOOD ERYTHROCYTES IN THE ADOLESCENTS INCLINED TO SHORT-SIGHTEDNESS AND MYOPIA
Yastrebtseva T.A.
Abstract
The present study included a total of 357 schoolchildren aged 14-17 years residing in a northern region of European Russia who presented with emmetropia (n = 186), pseudomyopia (n = 45), and myopia of different severity (n = 126). The hemoglobin levels and the number of blood erythrocytes in the patients of different groups were compared. The methods employed included the total blood count, determination of erythrocyte colour index, and the occurrence of hemoglobin levels below the normal-for-age value. It was shown that adolescents (boys and girls) presenting with pseudomyopia as well as girls with different degree of myopia had a significantly decreased hemoglobin level compared with the adolescents of either sex presenting with emmetropia. The number of erythrocytes in the girls with myopia was also lower than in their age-matched counterparts with emmetropia. Significantly more schoolchildren at the age of 14-17 with short-sightedness or predisposed to its development had a decreased hemoglobin level compared with their age-matched counterparts suffering emmetropia. It is concluded that a decrease in the hemoglobin level per blood unit volume compromises oxygen supply to the tissues , i.e. leads to hypoxia that in its turn impairs the functional abilities of the body and is one of the factors contributing to the development of myopia.
Russian Pediatric Ophthalmology. 2012;7(2):57-59
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ON THE PROBLEM OF DIFFERENTIAL DIAGNOSTICS OF A CORNEAL ULCER OF DIFFERENT ETIOLOGY IN THE CHILDREN (A CASE REPORT)
Seliverstova K.E., Vakhova E.S., Yani E.V., Ibragimova D.I.
Abstract
The authors report a case of a herpetic corneal ulcer complicated by the toxico-allergic eye reaction. At the early stage of the disease, it was interpreted as Acanthamoeba keratitis associated with the wearing of contact lenses. The diagnosis was based on the results of analysis of the clinical picture and course of the disease. It was later confirmed by additional studies and the results of antiviral therapy.
Russian Pediatric Ophthalmology. 2012;7(2):61-63
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CLINICAL TASKS
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Abstract
Russian Pediatric Ophthalmology. 2012;7(2):64-64
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