Vol 10, No 2 (2015)

We study the condition of hemoperfusion of the anterior eye segment in patients with myopia and evaluate the impact on its quantitative indicators of certain ophthalmologic topical drugs with potential vasotropic activity. We Investigated quantitative indicators of the eye anterior segments’ hemoperfusion, the average hemodynamic pressure in the anterior ciliary arteries, intraocular pressure and perfusion pressure in anterior segment of the eye in 149 patients (298 eyes) with myopia of a weak, medium or high degree (aged 7-22 years) and 32 persons (32 eyes) with emmetropia (aged 10-20 years) in the initial state and under the influence of two drugs: 2,5% solution of phenylephrine and 2% solution of dorzolamide hydrochloride. The following results are obtained. Hypoperfusion in anterior segment of the eye caused by anterior ciliaryarteries hypotony was revealed in myopia patients with decreasing of mean hemodynamic pressure in anterior ciliary arteries and perfusion pressure in anterior eye segment. Hypohemoperfusion tendency increased with degrees of myopia. Phenylephrin worked positively as a vasotropic drug to improve in anterior eye segment hemoperfusion parameters in patients with mild and moderate degrees of myopia. After phenylephrin instillation elevations of mean hemodynamic pressure in anterior ciliary arteries and perfusion pressure in anterior eye segment were determined in that patients. Elevation of perfusion pressure after dorzolamide instillation in patients with mild and moderate degrees of myopia was caused mainly by its hypotensive activity. The reliable changes of anterior eye segment perfusion pressure was not revealed in high myopia patients after using of both drugs. Phenylephrin can be used in the anterior eye segment hypoperfusioncorrection in myopia patients. The use of dorzolamide, given its predominantly hypotensive effect, in this pathology is impractical.

The article presents a family case of Best vitelliform macular dystrophy (Best’s disease) - autosomal dominant macular dystrophy with typical clinical presentation and staging of the disease flow. A daughter and a mother had diagnosed Best’s disease with different localizations (central and eccentric) and stages (psevdogipopion and pseudocyst) of the disease in the right eye and the same (atrophic) - in the left eye. Apart from that, the daughter had the optic disc drusen. We proved descriptiveness of optical coherence tomography and fundus autofluorescence imaging for confirmation of Best’s disease diagnosis, determination of the stage of the disease and identification of changes that cannot be detected with ophthalmoscopy, in retina, pigment epithelium and Bruch's membrane.

The conducted research covered the analysis of anesthetic support during 72 surgical operations of 52 children with retinal detachment. A comparison of two groups - basic (38 anesthesia) and control (34 narcosis) has been made. In both groups, premedikation and induction were the same. The anesthetic support was administered through the inhalation of oxygen, nitrous oxide and sevoflurane, and intravenous bolus dosing of propofol. Central analgesia was maintained through fractional intravenous injection of fentanyl. Laryngeal mask was used for airway management.In the main group at the request of the anesthesiologist, ophthalmosurgeon administered retro-bulbar anesthesia solutionof 0.75% naropin. Heart rate, ASIST, Addict, BPA, ECG had been controlled intraoperatively. Hemodynamic parameters in the main group during the operation were stable. However, in traumatic moment (endolasecoagulationof retina) tachycardia was observed with the patients of the control group. There were no any complications of combined analgesia. Re-introduction of naropin at the end of the operation led to decrease of pain syndrome and allowed to refuse the use of analgesics in the postoperative period in most children.Thus, the use of combination inhalation-retrobulbar anesthesia with the use of naropin of 0,75% gives sufficient depth of anesthesia and expands the number of pain medications in anesthetic support in children with eye conditions.

Peripheral defocus plays a significant role in refraction development. Spectacle lenses «Perifocal-M» allows to perform a correction of the central and peripheral refraction in the horizontal meridian differentially. The purpose was to determine the effect of «Perifocal-M» spectacles on the wave front aberrations, peripheral refraction and myopia development in children. 75 myopic children aged 9-14 with spherical equivalent cycloplegic refraction between -1,0 D and -6,0 D took part in the clinical prospective parallel cohort open study. Patients were randomly assigned to wear «Perifocal-M» or monofocal spectacles. It is noted that «Perifocal-M» spectacles form relative peripheral myopic defocus in the eye or decrease peripheral hyperopic defocus significantly, as well as induce positive spherical aberration. Decrease of the eye growth on 0,05mm, decrease of the myopic shift manifest refraction on 0,19 D, cycloplegic refraction on 0,11 D as compared to the control group were revealed after 6 months wearing of «Perifocal-M» spectacles. Decrease of the eye growth on 0,07mm, decrease of the myopic shift manifest refraction on 0,3 D, cycloplegic refraction on 0,27 D as compared to the control group were revealed after 12-18 months wearing of «Perifocal-M» spectacles. No one case of heterophoriadecompensation occurred while wearing «Perifocal-M» spectacles. «Perifocal-M» spectacles arrest the myopia progression in children.

We present a clinical case of the patient with a diagnosis «OU - atypical congenital strabismus. Abnormal development of the eye muscles. OD - moderate hyperopia with astigmatism, moderate amblyopia». The patient underwent two-step surgery with an interval of 4 years. During the first phase, it was discovered the absence of the lower and outer muscles on his right eye and was therefore carried out transposition of the internal rectus muscles to the projection of the bottom line. The second phase of the operation included: recession of the superior rectus muscle to 7.0 mm on the right eye; recession of the lateral rectus muscle of 10.0 mm on the left eye. During surgery it was discovered the following: in the right eye muscle fibers of the superior oblique muscle and the superior rectus muscle are in the same fascia and spliced. On the left eye outer rectus has an abnormal direction with respect to a limb: from the bottom up at an angle of 300. After surgery, the deviation amounted to (-)15 prism diopters, vertical component was removed.

We studied the dynamics of the retinoblastoma incidence in children of the Kemerovo region. There is a tendency to increased morbidity, including bilateral form. During the thirty-year period (1984-2013) the incidence rate in the region increased from 4,02 in the first study period (1984-1993) to 8,50 in the third period (2004-2013) per 100 thousand newborn babies. The frequency of such cases in the last decade was 1 to 11999 newborns. In the first decade of research bilateral lesion was observed in 16,7% of all cases, in the third - 41,4%. Gender ratio for the entire study period was as follows: boys - 55,2%, girls - 44,8%. In the age aspect the children of the first year of life were leading - 48,28%. Retinoblastoma had been diagnosed before the age of three years in 91,38 % of patients.