Vol 12, No 1 (2017)

Articles
THE DYNAMICS OF THE LENGTH OF THE ANTERIOR-POSTERIOR EYE AXIS FOLLOWING THE EXTRACTION OF UNILATERAL CONGENITAL CATARACTS WITH THE IMPLANTATION OF INTRAOCULAR LENSES IN THE CHILDREN DURING THE FIRST YEAR OF LIFE
Katargina L.A., Kruglova T.B., Egiyan N.S., Trifonova O.B.
Abstract
Introduction. Unilateral congenital cataracts in the children account for up to 16.0% of the total number of congenital cataracts diagnosed among the pediatric population. Aphakia is considered to be the most physiological method for the surgical treatment and correction of unilateral congenital cataracts in the combination with the implantation of intraocular lenses. The optical power of the lenses is calculated based on the results of evaluation of the dynamics of the length of the anterior-posterior eye axis in individual patients. Aim. The objective of the present study was to analyze the dynamics of the length of the anterior-posterior axis of the eyes in the children presenting with pseudophakia following the extraction of unilateral congenital cataract. Materials and methods. The study included a total of 77 children with unilateral congenital cataracts examined before and after the surgical treatment. Phacoaspiration in the combination with the implantation of intraocular lenses was performed in the patients at the age varying from 3 to 11 months. The infants underwent the ultrasound biometric study and the evaluation of the dynamics of the length of the anterior-posterior axis in the affected eye in comparison with that in the contralateral eye before they reached the age of 7 years. Results. The results of this study give evidence of marked variability of the dynamics of the length of the anterior-posterior axis of the eyes following the early surgical treatment of the children presenting with unilateral congenital cataracts. Conclusion. The differences in the tendency toward the change in the length of the anterior-posterior axis of the eyes following the surgical treatment of unilateral congenital cataracts in the children during the first year of life suggest the necessity of further in-depth investigations and the need for the regular follow-up of such patients for the purpose of choosing the proper approach to the correction of the refraction error and ametropia.
Russian Pediatric Ophthalmology. 2017;12(1):6-10
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THE EVALUATION OF THE TYPES OF FIXATION OF INTRAOCULAR LENSES DURING LENSECTOMY IN THE CHILDREN PRESENTING WITH MARFAN’S SYNDROME
Pershin K.B., Pashinova N.F., Cherkashina A.V., Tsygankov A.Y.
Abstract
Aim. The objective of the present study was to evaluate the results of lensectomy in the combination with intraocular lens implantation including various types of their fixation in the children presenting with Marfan’s syndrome. Materials and methods. The study included 16 children presenting with Marfan’s syndrome and congenital cataract (31 eyes) at the age from 3 to 16 (mean 9.8+-4.1) years treated in the Excimer Eye Centre during a period from 2003 to 2015. The best corrected visual acuity (BCVA) prior to the surgical treatment was estimated at 0.1-0.4 (0.32+-0.16). All the patients underwent early phacoemulsification of the cataract in the combination with the intraocular lens implantation after the standard ophthalmological examination. Various types of intraocular lens implants were applied, namely AcrySof SN 60AT (n=2), SN60WF (n=3), MA60AC (n=19), MA60BM (n=2), and toric SN60T5 (n=3). The choice of the method for the intraocular Implant fixation depended on the degree of lens ectopia, the capsule characteristics, and the age of the patient. Results. Three main types of lens fixation were identified, viz. the mixed type (n-5), intracapsular (n-15) and intrascleral (n= 11) types. The BCVA measured within 12-36 months after the surgical intervention: was 0.4-1.0 (0.78+-0.26). The dislocation of the implanted intraocular lens was documented in 10 children, including all the three cases in the group with the mixed type of fixation without suturing and two cases of membranous cataract. Lens dislocation developed in 6 eyes of the patients with the Intracapsular localization of the intraocular lens and in 7 other eyes of the children comprising this group. Secondary lens reposition was required in a single patient who had undergone intrascleral lens fixation. No cases of uveitis, retinal detachment, macular oedema, and other complications were documented. Conclusion. In all the cases of lensectomy in the combination with the intraocular lens implantation in the children presenting with Marfan’s syndrome, the well apparent improvement of the visual functions and reduction of the severity of ambliopathy have been achieved. The lowest frequency of postoperative complications and the best functional outcome of the surgical treatment were documented in the group of the children with the intrascleral fixation of the intraocular lens implants. However, further studies involving a large sample of the patients are needed to obtain the statistically significant data for the evaluation of the long-term outcomes of the surgical treatment of the children presenting with Marfan’s syndrome and the choice of the optimal method for the fixation of the intraocular lens implants.
Russian Pediatric Ophthalmology. 2017;12(1):11-16
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THE DIAGNOSTIC SIGNIFICANCE OF FLUORESCENCE ANGIOGRAPHY FOR THE EARLY DETECTION AND PROGNOSTICATION OF THE DEVELOPMENT OF ACTIVE RETINOPATHY OF PREMATURITY IN THE INFANTS BORN ON THE DEADLINES OF GESTATION
Saidasheva E.I., Lyubimenko V.A., Buyanovskaya S.V., Kovshov F.V.
Abstract
Aim. The objective of the present study was to elucidate the fluorescent angiographic characteristics, such as the features of retinal and choroidal microcirculation, depending on the duration of the active course of retinopathy of prematurity in the infants born on the deadlines of gestation (the gestational age of 21-26 weeks). Materials and methods. The study included 65 patients presenting with retinopathy of prematurity. A total of 102 sessions of fluorescence angiography (FA) of the retina were carried out, with 40% of the sessions being performed in duplicate. The gestational age of the infants ranged from 22 to 26 (mean 24.9+-1.0) weeks, their body weight at birth varied from 490 to 1,400 (mean BW 774.8+-152.6) g. All the patients were subdivided into 4 groups. Group 1 was comprised of 8 (12.3%) children at the initial stages of retinopathy of prematurity, group 2 consisted of 28 (43.1%) children presenting with threshold retinopathy of prematurity, group 3 was composed of 20 (30.8%) children with the recurring disorder, and group 4 involved 9 (13.8%) children experiencing induced regression of this pathology. The photographs of the fundus and digital video FA images were obtained with the use of the RetCam3 pediatric retinal camera (“Clarity”, USA). The 10% fluorescein solution was administered intravenously in the form of bolus injections at a dose of 7.5 mg/kg. Results. The present study has revealed some characteristic fluorescent and angiographic features of active retinopathy of prematurity in the extremely preterm born infants including instability of the retinal blood flow, variability in the filling of the choroid, various types of pathological branching of the blood vessels at the boundary between vascularized and avascular retina, etc. The comparative analysis of the angiograms and colour images of the fundus obtained with the use of the RetCam3 camera gave evidence of the high diagnostic value of the fluorescence angiography technique that provides the possibility for the early objective visualization and registration of the pathological changes in the retinal vasculature characteristic of the initial and threshold stages of the disease as well as for the reliable detection of the signs of its relapse (the local sites of re-proliferation) and regression of the pathology being considered. Conclusion. The application of the fluorescence angiography technique for the examination of the markedly prematurely born infants provides a safe and efficient tool allowing to greatly optimize both the early detection and prognostication of the development of active retinopathy of prematurity in the infants born on the deadlines of gestation.
Russian Pediatric Ophthalmology. 2017;12(1):17-22
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THE MORPHOLOGICAL STUDY OF THE RABBIT EYE SCLERA FOLLOWING THE SCLERA-STRENGTHENING OPERATIONS WITH THE USE OF UV CROSS-LINKED TRANSPLANTS
Bikbov M.M., Zainutdinova G.K., Kudoyarova K.I., Luk’yanova E.E., Khalimov A.R.
Abstract
Aim. The objective of the present study was the comparative evaluation of the morphological characteristics of the reaction of the ocular tissues following experimental scleroplasty with the application of the xenografts from UV-irradiated and non-irradiated pericardium. Materials and methods. To elucidate the morphological characteristics of the reaction of the eye tissues to experimental scleroplasty, we used histological sections of the 16 eyes of 8 rabbits. The animals were allocated to two groups. Those in group 1 underwent sclera-strengthening operations as described by Khatminsky with the use of UV cross-linked xenotransplants from the pericardium. Part of them was preliminarily subjected either to UV-irradiation at a wavelength of 370 nm and an irradiation power of 5 mW/cm2 for 20 minutes or to the treatment with a 0.5% aqueous solution of riboflavin during 30 minutes (the right eyes from 4 animals). The remaining rabbits comprised group 2 and were operated using the same procedure with the application of the xenotransplants from the non-irradiated pericardium. The left eyes of all the animals remained intact and serves as the controls. The enucleated eyes were subjected to the microscopic and histological examination within 2 weeks (two rabbits from each group) and 1 month after surgery. Results. The morphological study of the enucleated eyes obtained within 2 weeks after the surgical intervention gave evidence of only the mild aseptic inflammatory reaction in the form of a lean rim composed from lymphocyte-like cells buried deep in the sclera close to the transplants from the UV-irradiated pericardium. The histological studies carried out within 1 month after the operation have demonstrated the signs of formation of a connective tissue capsule. The sections through the sclera of the enucleated eyes with the use of the biological materials from the non-irradiated pericardium obtained 2 weeks after the operation at the borderline with the transplants exhibited the clearly visualized signs of aseptic inflammation with massive lympho-macrophage infiltration and the presence of a large amount of fibroblasts. Only isolated areas of the granulation tissue were identified within 1 month after the intervention. Conclusion. The histological study of the enucleated rabbit eyes conducted within 2 weeks after experimental scleroplasty has demonstrated the less pronounced reaction of the ocular tissues to the introduction of the UV-irradiated xenografts in comparison with that of the non-irradiated ones. One month after the surgical intervention with the application of the xenotransplants from the UV cross-linked pericardium, the histological signs of the formation of the capsules from the connective tissue were well apparent in the association with the mild inflammatory reaction of the ocular tissues. The animals operated with the use of the non-irradiated biological materials from the pericardium experienced massive inflammatory lympho-macrophage infiltration and exhibited only isolated areas of the developing granulation tissue.
Russian Pediatric Ophthalmology. 2017;12(1):23-26
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THE EVALUATION OF THE STATE OF CHOROID IN THE PATIENTS PRESENTING WITH UVEITIS OF DIFFERENT ETIOLOGY BASED ON THE RESULTS OF OPTICAL COHERENCE TOMOGRAPHY
Katargina L.A., Denisova E.V., Novikova O.V.
Abstract
The evaluation of the state of choroid in the patients presenting with uveitis is one of the promising directions in modern ophthalmological diagnostics because it provides the opportunity for obtaining the objective quantitative characteristics of the activity of the inflammatory process and thereby makes it possible to more accurately estimate the effectiveness of the treatment. It has been shown that the thickness of choroid considerably increases during the acute phase of Vogt-Koyanangi-Harada disease, active uveitis associated with Behcet’s disease, sarcoidosis, and toxoplasmosis and returns to the normal value under the influence of the treatment. In certain cases, the thickness of choroid decreases in comparison with that in the healthy eyes. The thinning of choroid was documented also at the stage of the clinical remission of birdshot retinochoroidopathy, Fuchs syndrome-associated uveitis, posterior non-infectious and idiopathic pan-uveites. It can possibly be the result of the atrophy of choroid due to the inflammatory and ischemic processes. Unfortunately, the available literature data have been obtained in disconnected studies of the choroid of the patients suffering from uveitis that involved only the small number of the patients and were confined to a few selected etiological and pathogenetic structural variants of this condition.
Russian Pediatric Ophthalmology. 2017;12(1):27-34
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OPTICAL BIOMETRY OF THE EYE: THE PRINCIPLE AND THE DIAGNOSTIC POTENTIAL OF THE METHOD
Kiseleva T.N., Oganesyan O.G., Romanova L.I., Milash S.V., Penkina A.V.
Abstract
Optical biometry is based on the laser interferometry technique for the measurement of the biometric characteristics of the eyes, such as the antero-posterior axial length, anterior chamber depth, lens and retina thickness, corneal diameter and parameters of keratometry. The present article was designed to overview the basic principles of this method, its advantages and disadvantages, indications and contraindications for its application. The comparative analysis of the characteristics of the following optical biometric devices was undertaken: IOL-Master 500, Lenstar LS 900, Aladdin, OA-1000, OA-2000, Al-3000, Al-Scan, Galilei G6, IOL-Master 700.
Russian Pediatric Ophthalmology. 2017;12(1):35-42
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THE CRANIOFACIAL INJURY IN THE CHILDREN COMPLICATED BY ORBITAL ENCEPHALOCELE AND PROLAPSE OF THE UPPER FORNIX CONJUNCTIVA
Yatsenko O.Y., Koroleva E.A., Karaseva O.V.
Abstract
The cranio-orbital injuries are considered to be the most serious consequences of the combined craniofacial trauma. They are characterized by the complicated clinical picture and are responsible for the high rates of disability among the affected patients. It accounts for the necessity of recruiting the highly specialized multi-disciplinary teams of specialists to assure the comprehensive approach to the treatment of the victims. The analysis of the relevant literature publications has demonstrated that the cranio-orbital injuries account for 6% up to 64% cases of craniocerebral damages and 34% of all combined traumas. The children at the age under 7 years more frequently experience fractures of orbital bones than the adult subjects due to the peculiar structural features of the children’s skulls. Encephalocele is an extremely rare complication of the cranio-orbital injuries that can either acquire the acute form or develop gradually within a few years after the injury. Orbital hernia may be associated with the following complications for the organs of vision and their accessory apparatus: exophthalmos, diplopia, rupture of the optic nerve, oedema of the periorbital tissues, retinal detachment, enophthalmos, subconjunctival hemorrhage, complete loss of vision, and the rupture of the eyeball. Prolapse of the upper fornix conjunctiva is an equally rare complication of the injury to the orbital structures. To the best of our knowledge, the available literature publications contain only a single report of such condition. The present article describes the original clinical observations of orbital encephalocele accompanied by the prolapse of the upper fornix conjunctiva in the children who experienced a severe combined craniofacial injury. One patient (a 10 year old boy) suffered from the serious combined trauma resulting from his fall from the fifth floor. Orbital hernia developed within 5 days after the accident. The second case was that of a girl presenting with a severe combined injury inflicted to her during the road traffic accident. She developed the complication in the form of orbital encephalocele on day 13 after the accident. In both cases, the patients suffered from the well apparent paraorbital oedema, exophthalmos with the downward displacement of the eyeball, and the prolapse of the upper fornix conjunctiva.
Russian Pediatric Ophthalmology. 2017;12(1):43-49
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THE ХLII CONGRESS OF EUROPEAN PAEDIATRIC OPHTHALMOLOGICAL SOCIETY (EPOS-2016) «PAEDIATRIC NEURO-OPHTHALMOLOGY» ZURICH, SEPTEMBER 23-25, 2016
Fomina N.V., Kogoleva L.V.
Abstract
Russian Pediatric Ophthalmology. 2017;12(1):50-51
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THE III EUROPEAN CONFERENCE ON ANIRIDIA DUISBURG, GERMANY, 26-28 AUGUST 2016
Kogoleva L.V., Tarasenkov A.O.
Abstract
Russian Pediatric Ophthalmology. 2017;12(1):52-54
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