Vol 11, No 1 (2016)

Articles
The methods for the surgical correction of pareses, paralyses of the superiorinferior oblique muscle in the children
Babadjanova L.D., Narzullaeva D.U., Gopurov M.K.
Abstract
Aim. The objective of the present study was to estimate the effectiveness of the surgical correction of hyperfunction of the inferior oblique muscle in the children depending on the degree of overaction. Materials and methods. We undertook the analysis of hyperactivity of the inferior oblique muscle in 78 children (128 eyes) at the age varying from 4 to 15 years. All the patients were followed up for 9 years. The ophthalmological examination included the determination of vertical deviation with the use of the Hirschberg test and prisms, the study of eyeball movements in 8 gaze directions, the Bielschowsky darkening wedge test, the assessment of the character of vision by means of the Worth's four-dot test, visiometry, dioptos copy, and ophthalmoscopy. Results. The patients underwent myotomy, anterior transposition or myoectomy of the inferior oblique muscle with recession taking into consideration the degree of hyperfunction. Conclusion. Myotomy eliminates vertical deviation only in case of grade 1 overaction. Anterior transposition of the inferior oblique muscle provides an efficient tool for the surgical treatment of the condition being considered because it permits to rapidly correct the large angle of vertical strabismus in the patients presenting with grade 2 or 3 hyperfunction of the inferior oblique muscle. It is recommended to treat grade 4 overaction my means of myoectomy with a recession of up to 10 mm.
Russian Pediatric Ophthalmology. 2016;11(1):6-8
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The experience with the application of Azidrop in the ophthalmological practice
Vorontsova T.N., Vorontsova O.A.
Abstract
Introduction. The infectious inflammatory diseases of the eyes are characterized by the high prevalence and the potential risk of impairment of visual acuity. Background. It is widely known that the uncontrollable use of antibacterial medications is a major cause of the growing resistance of microorganisms to antibiotic agents. The use of the highly efficient preparations that have never before been employed for the local application in the ophthalmological practice as the basic ingredients for the development and production of the novel eye drops appears to be a very promising area for the further work. One of such medications is an Azidrop ophthalmic solution containing azithromycin at a concentration of 15 mg/g. Aim. The objective of the present study was to evaluate the clinical and antimicrobial effectiveness of the Azidrop ophthalmic solution for the treatment of the inflammatory diseases of the bacterial nature. Materials and methods. A total of 46 patients including 25 children and 21 adults (72 eyes) who presented with the inflammatory diseases of the anterior segment of the eye were available for the examination. All the patients were treated with the use of the Azidrop ophthalmic solution twice daily during 3 days. Sowing of microbial flora contained in the discharge from the conjunctival cavity was done before and after the course of therapy to estimate its sensitivity to antibiotics. Moreover, we evaluated the symptoms of inflammation based on the 4-point scale and performed biomicroscopy of the cornea and conjunctiva using fluorescein sodium and lissamine green as staining solutions. Changes in the symptoms of inflammation were repeatedly evaluated on days 5 and 7 after the initiation of therapy. Results. The microorganisms were identified in 87.5% of the primary isolates from the conjunctival cavity contents. Three days after the onset of therapy using the Azidrop ophthalmic solution, the positive results of microbiological analysis were obtained only in 19.5% of the patients as appeared from the total disappearance of Staphylococcus aureus and hemoliticus, Streptococcus viridans, and Enterococcus. All the patients exhibited the tendency toward alleviation of the inflammatory reaction of the conjunctiva and reduction of the amount of discharge from the conjunctival cavity as early as the second day of the treatment. The clinical recovery and improvement of the eyes’ condition was documented in 52.8% and 44.4% of the patients respectively within 5 days after the onset of therapy (i.e. 2 days after its termination). 80.6% of the patients experienced clinical recovery and 18.1% improvement of the eyes’ conditions 4 days after the withdrawal of the Azidrop ophthalmic solution. These observations give evidence of the prolonged action of the Azidrop ophthalmic solution. An even faster dynamics of cessation of discharge from the conjunctival cavity was recorded. It was virtually absent in 75.5% and 94.4% of the patients on days 5 and 7 from the onset of therapy respectively. Discussion. Our experience with the application of the Azidrop ophthalmic solution in the ophthalmological practice confirmed that azithromycin is possessed of the high antimicrobial activity with respect to the most common bacterial pathogens responsible for the development of the inflammatory eye diseases as revealed by the microbiological methods. It can be argued that even a short course of therapy with azithromycin produces an excellent clinical effect and is fairly well tolerated by the patients. Moreover, the prolonged action and beneficial effect of this antibiotic on the state of corneal epithelium have been demonstrated. Conclusion. 1. The treatment of the inflammatory diseases of the anterior segment of the eye with the Azidrop ophthalmic solution containing 15 mg/g of azithromycin produces the well pronounced clinical effect. 2. The Azidrop ophthalmic solution-based preparations can be recommended for the wide application in the pediatric ophthalmological practice for the management of the infectious diseases of the anterior segment of the eye. This treatment can be prescribed to the patients within the first year after birth.
Russian Pediatric Ophthalmology. 2016;11(1):9-13
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The spectrum of mutations in the patients presenting with ABCA4-associated Stargardt's disease in a Russian population
Zol'nikova I.V., Ivanova M.E., Strel'nikov V.V., Levina D.V., Demenkova O.N., Tanas A.S., Rogatina E.V., Egorova I.V., Rogova S.Y., Prikazyuk E.Y.
Abstract
Introduction. Stargardt's disease is a hereditary retinal dystrophy characterized by the early manifestation and the progressive deterioration of visual acuity. The spectrum of mutations in the ABCA4 gene associated with this pathology in the Russian Federation has not been fully investigated. Aim. The objective of the present study was to elucidate the spectrum of mutations in the ABCA4 gene in the Russian patients presenting Stargardt's disease. Materials and methods. The study included a total of 38 unrelated patients at the age varying from 6 to 48 (mean 20 ± 8.9) years having the clinically confirmed diagnosis of Stargardt's disease. The search of mutations in DNA extracted from the peripheral blood lymphocytes of the patients was carried out with the use of a set of oligonucleotide primers (Ion Ampliseq Inherited Disease Panel; Life Technologies, USA). The Ion Torrent PGM Sequencer (Life Technologies, USA) was used for the parallel semiconductor sequencing of the gene-coding regions. All the patients underwent the standard ophthalmological examination, electroretinography, optical coherence tomography, and fundus autofluorescence. Results. We established the spectrum of mutations in the ABCA4 gene in the patients of a Russian population suffering from autosomal-recessive Stargardt's disease. We identified 45 alleles responsible for the development of this condition. 14 of them had been earlier described in the Russian patients while 19 were discovered for the first time in this country although they had been known to occur in other populations. Moreover, we described 12 novel heterozygous variations, viz. c.230T>A (rs61748527), c.4956T>G (rs61750561), c.2820>G (rs81749445). c.5226delT, c.2537A>T, c.57353T, c.893delG, c.702 insATC, c.3896T>G, c.1356delA, c.1341delGAT, and c.231insGAAAA. Discussion. The study has revealed the rather variable phenotype in the patients presenting with ABCA4-associated Stargardt's disease. A wide variety of mutations were shown to be responsible for the difference of the clinical picture of this condition in individual patients. The comparison of the genotypes and the phenotypes has demonstrated the differential effect of the concrete mutations. Conclusion. The spectrum of mutations in the patients presenting with ABCA4-associated Stargardt's disease in the surveyed Russian population is different from that in other populations. We have revealed 12 previously unknown mutations; moreover 19 mutations have been described for the first time in this country although they had been previously known to occur in other populations.
Russian Pediatric Ophthalmology. 2016;11(1):14-22
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The surgical treatment of primary congenital (infantile) glaucoma
Khamroeva Y.A.
Abstract
Aim. The objective of the present study was to evaluate the effectiveness of the surgical intervention for the treatment of the children at the age from 3 to 10 years suffering from primary congenital (infantile) glaucoma depending on the severity of the morphometric changes. Materials and methods. A total of 16 patients (30 eyes) were available for the examination. Three patient (6 eyes) presented with mild glaucoma, 8 ones (15 eyes) with advanced glaucoma, and 5 (10 eyes) with end-stage glaucoma. All the patients underwent the surgical treatment supplemented by a course of neuroprotective therapy during the postoperative period (6 months after surgery). Results. Based on the results of the preoperative examination, the children with mild glaucoma underwent the surgical intervention on 5 eyes with the use of non-penetrating deep sclerotomy. The patients with advanced glaucoma and the children with terminal glaucoma were operated on 15 and 8 eyes respectively by means of “ab externo” sinusotrabeculotomy. The filtering operation was performed on two eyes of the children with terminal glaucoma with the use of our original method. Conclusion. The above surgical technologies allowed to decrease the frequency of intra- and postoperative complications by 15%, avoid secondary interventions, decrease intraocular pressure in 12.3% of the patients, and improve visual acuity by 0.15 in comparison with its initial value.
Russian Pediatric Ophthalmology. 2016;11(1):23-26
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The influence of melatonin and dexamethasone instillations on the clinical course of uveitis and the biochemical processes in the aqueous humour of the anterior chamber of the eye (an experimental study)
Chesnokova N.B., Beznos O.V., Beyshenova G.A.
Abstract
Introduction. The problem of the treatment of uveitis has the important socio-medical implications bearing in mind the high prevalence of this pathological condition frequently affecting the subjects of the employable age. Uveitis is characterized by the enhanced production of free radicals in the eye tissues and marked activation of oxidative reactions that gradually aggravate the pronounced changes in the immune system that, in their turn, promote the development of oxidative stress. Aim. This study was designed to evaluate and compare the influence of melatonin and dexamethasone or their combination on the clinical symptoms and local metabolic processes in the aqueous humour of the anterior chamber of the rabbit eyes. Materials and methods. The present study was based on the rabbit model of immunogenic anterior uveitis developed by the subcutaneous injections of the normal equine serum followed by its intravitreal administration. We investigated the influence of instillations of a 0.1% melatonin solution and a 0.4% dexamethasone solution or their combinations on the clinical course of uveitis and the biochemical processes in the aqueous humour of the anterior chamber of the eye including the anti-oxidative activity, total protein and alpha-2 macroglobulin contents as well as the leukocyte count. Results. It was shown that instillation of melatonin either alone or in a combination with the dexamethasone solution reduced the severity of the inflammatory processes associated with uveitis. Melatonin, similar to dexamethasone, decreased palpebral oedema and iridial swelling. The two medication instilled successively produced a synergic effect on palpebral oedema, conjunctival hyperemia, corneal and iridial oedema. A significant decrease of protein and alpha-2 macroglobulin levels in comparison with the same values in the aqueous humour of the anterior chamber of the eye of the untreated animals was documented within 8 days after the induction of experimental uveitis. The similar effects of dexamethasone was even more pronounced. At the same time, the instillation of melatonin more significantly than that of dexamethasone reduced the number of leukocytes in the aqueous humour of the anterior chamber. It is worthwhile to note that instillations of melatonin, unlike those of dexamethasone, caused a significant increase in the anti-oxidative activity in the aqueous humour of the anterior chamber. Discussion. The instillations of melatonin make it possible to reduce the intensity of the inflammatory processes associated with experimental uveitis, enhance the anti-oxidative potential in the eye tissues, and decrease the permeability of the blood-ocular barrier. Conclusion. It is concluded that the introduction of melatonin instillations in the combined treatment of uveitis may improve the effectiveness of therapy of this condition.
Russian Pediatric Ophthalmology. 2016;11(1):27-32
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The federal clinical guidelines on “Diagnostics, medicamentous and surgical treatment of the children presenting with congenital glaucoma”
Katargina L.A., Mazanova E.V., Tarasenkov A.O., Saydasheva E.I., Brzheskiy V.V., Volodin P.L., Gusarevich O.G., Fomina N.V.
Abstract
Russian Pediatric Ophthalmology. 2016;11(1):33-51
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The Xth Annual Congress of the Russian Association of Specialists in Perinatal Medicine “Modern perinatology: organization, technologies, quality” (Moscow, 28-29 September, 2015)
Mazanova E.V.
Abstract
Russian Pediatric Ophthalmology. 2016;11(1):52-55
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The Xlllth Congress of the International Ocular Inflammation Society (San-Francisco, 27-27 September, 2015)
Denisova E.V.
Abstract
Russian Pediatric Ophthalmology. 2016;11(1):56-58
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Aleksandra Vasil’evna Khvatova (on the occasion of her 90th birthday anniversary)
- -.
Abstract
Russian Pediatric Ophthalmology. 2016;11(1):59-63
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