Russian Pediatric Ophthalmology

The authors present their many-year experience with the application of modern hypotensive medications for the treatment of various forms of congenital glaucoma in the children depending on the stage of pathology and the degree of its compensation. The data obtained were used to estimate the effectiveness of antiglaucoma agents belonging to different pharmacological groups and propose the algorithm for medicamental therapy of congenital glaucoma in the children including young ones.

This paper is designed to report the results of the application of histochrome for the treatment of the children presenting with «pre-plus» disease and concomitant active retinopathy of prematurity. The preparation was administered intramuscularly in the form of a 0.02% solution. The effectiveness criteria included the time between the onset of the disease and the development of its threshold stage, the area of avascular retina by the time of emergence of the threshold stage, and the frequency of spontaneous regression and beneficial outcomes of retinopathy of prematurity. The results of histochrome injections given to 25 children (50 eyes) were compared with those obtained in the control group comprised of 16 children (32 eyes). The patients of both groups were matched not only for somatic parameters but also for the severity of clinical symptoms of retinopathy of prematurity. It was shown that histochrome injections to the children exhibiting large areas of avascular retina at the stages of pre-retinopathy, pre-threshold plus-disease, and pre-plus disease (1) increased the frequency of spontaneous regression of the pathological process (to 44.0% compared with 12.5% in controls) and (2) slowed down its development into the threshold stage (the period from the onset of manifestations of retinopathy of prematurity to the threshold stage was as long as 0.7-9 (mean 4.11 ± 0.57) weeks compared with 0.6-3.5 (mean 2.28 ± 0.19) weeks in controls. Taken together, these changes promoted the reduction of the area of avascular retina by the time of laser coagulation. As a result, the cicatrical changes in the subsequent period were less pronounced. Moreover it allowed to postpone the surgical intervention till the child becomes older and therefore is at a lower risk due to the less aggravated somatic condition. (3) Finally the effectiveness of laser coagulation was enhanced.

Two clinical cases of retinal astrocytic harmatoma (calcified and non-calcified forms) are presented that illustrate the important role of spectral optical coherent tomography in diagnostics of this pathology.

The potential local and systemic complications of superselective intra-arterial chemotherapy used to treat refractory and advanced forms of retinoblastoma are considered in conjunction with the currently available measures of their prevention. In addition, possible causes of unsuccessful outcomes of this treatment modality are discussed.

Stavropol State Medical Academy This study included a total of 70 patients of whom 25 presented with suspected glaucoma, 25 with the initial stage of glaucoma, and 20 with advanced stages of the disease. All the patients were found to have the increased levels of IFN-γ, IL-1β, and TNF-α in the lacrimal fluid and blood sera depending on the severity of glaucoma. Moreover, advanced glaucoma was associated with the enhancement of IL-17 in the lacrimal fluid. The patients with glaucoma exhibited the predominantly Th-1 variant of the immune response. Switching to the Th2 variant occurred at the later stages of the pathological process.

The present literature review concerns hydrodynamics and the development of concomitant disorders in the patients suffering cervical spine osteochondrosis. Roughly 40% of such patients present with a moderate reduction of intraocular pressure at the affected side as evidenced by the results of clinical examination, computed and magnetic resonance tomography and neuropathological examination. These observations are consistent with the data on the pathogenetic mechanisms underlying this pathology. In the majority of the patients, reduction of intraocular pressure is associated with lens dilatation and retinal pallor revealed during eye ground ophthalmoscopy as well as other pathological manifestations caused by disturbed innervations, insufficiency of cerebral circulation and ischemia. It is concluded that these symptoms may be regarded as ophthalmological signs of cervical spine osteochondrosis.

The many-year experience with the treatment of more than 3,000 young children provided a basis for the development of the algorithm for the treatment of congenital pathology of the tear passages (dacriocystitis of newborn infants, atresia of the nasolacrimal duct, dacriocystocele) taking into consideration the patients’ age. The main forms of the surgical intervention are described in conjunction with the principles of medicamental therapy at different stages of the treatment.

Ocular toxocarosis in the children is currently a challenging problem in pediatrics. This paper is devoted to the description of several cases of this pathology encountered in our clinical practice.