Vol 13, No 1 (2018)

Articles
APPLICATION SITEFILTER POINTS IN THE PREVENTION OF DEVELOPMENT AND PROGRESSION OF RETINOPATHY OF PREMATURITY (PRELIMINARY RESULTS)
Epikhin A.N., Epikhina Y.N., Ushnikova O.A., Ushnikov A.N.
Abstract
Objective. To study a method of prophylaxis of retinopathy at the stage of nursing of premature baby and evaluate the results. Material and methods. This method has been applied during the year on the basis of the Perinatal center of the Rostov region and the ophthalmic branch of the Rostov regional children’s clinical hospital. For this study were selected two groups of patients 50 children (100 eyes) from 26.5 to 36 weeks gestational age (GW) and with birth weight from 650 to 2650 grams. All the children were divided into two groups - study and control of 25 children (50 eyes) each. In the main group since birth to full maturation of the retina or regression of the disease after surgical laser treatment used safety glasses. Results. Preliminary data showed that the application of protective red glasses while observing the basic rules of nursing preterm infants, reduced the development of PH 16% and the need for laser treatment by 20%. Conclusions. Occlumeny sitefinity method is the first method of ophthalmic prevention of occurrence and development of retinopathy of prematurity, keeping the retina intact, allowing it to develop in light conditions close to natural in utero from the moment of premature to the natural time of birth of the child.
Russian Pediatric Ophthalmology. 2018;13(1):6-13
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THE POSSIBILITY OF USAGE MOXIFLOXACIN 0.5% SOLUTION IN PERIOPERATIVE PROPHYLAXIS IN CHILDREN
Zaytseva M.V., Brzheskiy V.V., Malysheva M.O., Baranova T.V., Smol’janinova T.V.
Abstract
Introduction. Nowadays the problem of postoperative endophthalmitis after intraocular operations remains unresolved. The aim of our research was to study the efficacy of a 0.5% solution of moxifloxacin in the perioperative prophylaxis of children. Material and methods. The study included 97 healthy children (113 eyes) aged from 1 month to 17 years. The swabs from conjunctival sac were taken three times. Results. The growth of microflora was detected in the conjunctival sac at 67.3% of cases. At 45.6% of cases Staphylococcus epidermidis was observed. The highest sensitivity of isolated microorganisms to Antibacterial drugs that are used topically in ophthalmology was shown to the moxifloxacin (95.8 %), ciprofloxacin (94,83%) and levofloxacin (90,5%). Staphylococcus epidermidis was discovered more often in the conjunctival cavity (53,3%, n=16) on the first swab in the second stage of the study. All microorganisms were sensitive to moxifloxacin. After taking a swab, the installation of 0.5% solution of moxifloxacin 1 drop 4 times daily the day before surgery was prescribed. The same drops were used and the second swab was taken in 1 hour and 30 minutes before surgical operation. In 9 cases (30%) Microflora was detected again, at 88.9% of the cases Staphylococcus epidermidis (n=8) was observed. 1 drop 4 times a day for 7 days of 0.5% solution of moxifloxacin was prescribed after surgery and after the course of antibiotic therapy third swab was taken. Microflora was detected in the eyes of two children also in the third study. Instillation of 0.5% solution of moxifloxacin is quite effective in the perioperative antibiotic prophylaxis of infectious complications of intraocular operations and significantly reduces the frequency of detection of microflora in the conjunctival cavity.
Russian Pediatric Ophthalmology. 2018;13(1):14-20
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ROLE OF OCT-ANGIOGRAPHY IN STUDYING OF PATHOGENESIS, DIAGNOSTICS AND MONITORING THE MACULAR TELANGIECTASIES IN CHILDREN
Katargina L.A., Denisova E.V., Osipova N.A., Kogoleva L.V., Tarasenkov A.O., Belova M.V., Novikova O.V.
Abstract
The purpose. to assess the potential of OCT-angiography in studying pathogenesis, diagnosing and monitoring macular telangiectasias of various genesis in children and adolescents. Material and methods. We examined and treated 4 children (5 eyes) aged from 12 to 17 years with idiopathic macular telangiectasias (2), developed against the background of Coat’s disease (1) and diabetic retinopathy (1). The examination included standard ophthalmologic inspection, as well as optical coherence tomography and OCT-angiography (RS-3000 Advance AngioSca, Nidek, Japan). Two children underwent transpupillary laser coagulation of telangiectasias (2 and 3 sessions), two received an intravitreal injection of an inhibitor of angiogenesis. Results. Ophthalmoscopically in all children microaneurysms were localized in the macular and paramacular zones and were accompanied by the development of retinal edema. According to OCT-angiography, all children had pathological structural changes (microaneurysms, vascular artery abnormalities, changes in the density of the vascular pattern) of superficial and to a greater extent deep retinal capillary plexuses. As a result of the treatment, 3 children (4 eyes) had clinically noted decrease in the number of microaneurysms. According to the data of optical coherence tomography, there was positive dynamics in decrease of the height of the retinal edema from 49 to 320 μm, аccording to OCT angiography, showed a decrease in the number of microaneurysms in the superficial and especially in the deep plexus, and in a child with diabetic retinopathy there was also a slight increase in the vascular density of the deep capillary plexus. Сonclusion. According to OCT-angiography, development of macular telangiectasias in children is accompanied by preferential changes in the deep capillary plexus, which indicates the pathogenetic significance of microcirculatory disturbances at this level. The method also reveals its value in monitoring the disease.
Russian Pediatric Ophthalmology. 2018;13(1):21-25
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MANUAL AND YAG-LASER ANTERIOR CAPSULORHEXIS SURGERY OF CONGENITAL ECTOPIA OF THE LENS IN MARFAN SYNDROME IN CHILDREN
Katargina L.A., Kruglova T.B., Arestova N.N., Egiyan N.S.
Abstract
Purpose. is to optimize the tactics of performing anterior capsulorhexis in children with congenital lens subluxation in Marfan syndrome with the use of manual and YAG - laser technique. Material and methods. There were observed 25 patients (34 eyes) aged 4 to 11 years old with lens subluxation: 7 children (10 eyes) with congenital cataract and 18 patients (24 eyes) of the clear crystalline lens in Marfan syndrome. The degree of ectopia was different: 14 eyes - 1 degree, 16 eyes-2 degree and 4 eyes-3 degree of crystal ectopia. Manual circular continuous capsulorexis performed 15 eyes in 12 childrens, YAG-laser capsulectomy-19 eyes in 13 children. Results. Use of YAG - laser equipment allowed to excise planned part of of the anterior capsule without mechanical pressure on not fixed lens. Full of YAG-laser anterior capsulorhexis could not be executed in eyes with 3 degree subluxation of the lens (a significant portion of the anterior capsule is covered with an iris). Manual method allowed to execute anterior capsulorhexis at any degree of subluxation of the lens, but required multiple manipulations on the anterior capsule because of clinical and anatomical features anterior capsule in eyes with subluxation of the lens, which significantly prolonged the time of surgery, increasing the risk of developing exudative and proliferative reactions. YAG - laser anterior capsulotomy (dissection of the anterior capsule by YAG laser) with the completion of capsulotomy with the help of instrumental method increases the quality of the surgery. Conclusion.To perform anterior capsulorhexis in children with lens subluxation 1 and 2 degrees can be applied a manual and YAG-laser methods, each of which has its advantages and disadvantages.
Russian Pediatric Ophthalmology. 2018;13(1):26-30
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A CHANGE OF THE LENGTH OF THE ANTERO-POSTERIOR AXIS OF THE EYE IN THE CHILDREN PRESENTING WITH HYPEROPIA FOLLOWING FEMTOSECOND LASER-ASSISTED IN SITU KERATOMILEUSIS: 3 YEAR FOLLOW-UP
Kulikova I.L., Pashtaev N.P., Gagloeva A.V., Shlenskaya O.V., Chapurin N.V.
Abstract
Aim. The objective of the present study was the analysis of the changes in the length of the antero-posterior axis of the eye (AL) in the children and adolescents presenting with hyperopia and anisometropia in 3 years after femtolaser-assisted in situ keratomileusis (FS-LASIK). Material and methods. The study included 33 patients at the age from 5 to 16 years divided into two groups. Group 1 was comprised of the patients having initially the mean spherical refractive equivalent (SE) +3.69 D. Those of group 2 had initial SE +5.88 D. In all the patients, FS-LASIK was carried out at the amblyopic eye in the absence of the positive results of the conventional conservative treatment. Results. During three years after FS-LASIK, AL of the treated patients in the first group increased by 0.41 mm and reached the mean value of 22.41 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.92 mm and became equal to 23.47 mm on the average with SE equaling +0.81 D. AL of the patients in the second group increased by 0.29 mm and reached the mean value of 21.59 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.97 mm and became equal to 23.32 mm on the average with SE equaling +0.62 D. Conclusion. During three years after hyperopic S-LASIK, the minimal growth of the antero-posterior axis of the eye was documented in the children presenting with hyperopia (+5 D) whereas its length increased by more than 0.29 mm. In the children with hyperopia of less than +5 D, it increased by 0.41 mm. It is concluded that prognosis of the results of femtosecond laser-assisted in situ keratomileusis leading to the alteration of the refraction in the amblyopic eye with the initially moderate or high-degree hyperopia should be made taking into consideration that AL continues to change in the cource of further growth of the child.
Russian Pediatric Ophthalmology. 2018;13(1):31-37
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A NEW METHOD OF ASSESSMENT ZONULAR LENS
Tarutta E.P., Harutunayn S.G., Tarasova N.A., Khandzhyan A.T., Khodzhabekyan N.V.
Abstract
Purpose. To compare the wave front aberrations and their changes under the action of cycloplegia in eyes with myopia and hyperopia. Material and methods. We examined 46 patients: 20 (39 eyes) with myopic (average -5.2±1.5 D) and 26 patients (53 eyes) with hyperopic refraction (mean refraction +3,1±1,15 D) aged 5 - 17 years (average 11.6±0.6 years). All the patients underwent aberrometry in a darkened room before and after medical cycloplegia (instillations of 1% cyclopentolate dihydrochloride twice, with an interval of 10 minutes, aberrometry in 40 minutes after the first instillation) with the aberrometer divice OPD-ScanIII, Nidek. Result. Significant differences: horizontal trefoil (C8) and horizontal coma (C7) before cycloplegia in myopia was significantly higher, and their changes under cycloplegia significantly lower or absent. The difference of these aberrations, with are associated with the dislocation of the crystalline lens, decentration of the optical elements of the eye, provides the evidence of weak zonular tension in the eyes with myopia. The method of assessing zonular on the dynamics of the polynomias C8 and C7 in the background of cycloplegia was developed. Conclusion. The developed method of indirect assessment of the condition of the zonular lens according to the comparative aberrometry before and after cycloplegia recommended for prognosis of postnatal refraktogenesis and evaluation of progressive myopia treatment effectiveness.
Russian Pediatric Ophthalmology. 2018;13(1):38-41
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CONSEQUENCES OF BURN INJURY OF ADNEXA IN CHILDREN. THE EFFECTIVENESS OF SURGICAL TREATMENT
Filatova I.A.
Abstract
Аim. Тo assess the effectiveness of surgical treatment of consequences of burn injury of adnexa in children. Material and methods. The analysis of clinical material over the past 10 years. The clinical group consisted of 59 patients (44 - male, 15 - female) with the consequences of burn injury of adnexa in age from 2 months to 18 years (m = 9.17 ±3.23 years). The burn trauma were the following: thermal (flame, hot objects, gas explosion) - 43, chemical (acid, alkali) - 11, combined (melted lead/glass) - 5. The time that has passed after the burn until the first stage of surgical treatment ranged from 1 month to 2 years (m= 9.7 ± 5.1 months). The author describes in detail the clinical picture, noting that significant lagophthalmos is dominated by the consequences of thermal burns, the consequences of chemical burns occurred entropion, symblepharon, leucoma. 11 patients had anophthalmos. In all, 121 operations were performed in 59 patients (1 to 4 stages, m = 2,1±1,1) with an interval from 3 to 12 months (m=8.3 months): removal of lagophthalmos with method of local plastics or free skin grafting; elimination of symblepharon or reconstruction of the conjunctival cavity with lips/cheeks’ mucous grafting; the strengthening of the eyelids’ edges, eyelashes plastic. The technics of the operation is described. Follow up period for patients from 6 months to 13 years (m=6,7±2,1). Results. Wound healing in all cases took place in the usual time. Skin sutures were removed after 7-9 days, traction sutures in 3 weeks, blepharorophy in 1-6 months. Engraftment of the transplanted free skin and mucous’ grafts was without a significant reduction. Visual function were preserved and improved in all the cases (44 patients). Cosmetic contact lenses were chosen in 4 patients with Vis = 0. A stable position of the prosthesis achieved in patients with anophthalmos. Conclusion. Consequences of burn injury of adnexa in children are diverse and require a differentiated approach to the choice of timing, priority, and methods of surgical treatment. Eyelid plasty is advisable to perform in the “cold” period after the completion of processes of scar tissue formation in the absence of threats to the condition of the eye.. Reconstruction should be performed at any time to prevent the development of ulcers or perforation of the cornea in the presence of the inversion of eyelids, symblepharon, significant lagophthalmos causing suffering of cornea.
Russian Pediatric Ophthalmology. 2018;13(1):42-45
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INVESTIGATION OF T-REGULATORY CELLS IN PREMATURY INFANTS
Kuznetsova Y.D., Balashova L.M., Bykovskaya S.N.
Abstract
Violation of the regulation of congenital immune reactions plays an important role in the etiology of common and serious neonatal complications in prematurely born children such as bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity and others. This review is devoted to the study of one of the indicators of cellular immunity - T-regulatory cells CD4 + CD25 + FoxP3 + CD127low in prematury infants. Further studies of immunity and in particular T-regulatory cells in premature infants in various diseases, including retinopathy of prematurity, will further develop pathogenetically substantiated correction of immunological disorders to prevent their occurrence and progression.
Russian Pediatric Ophthalmology. 2018;13(1):46-53
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MANIFESTATIONS OF IHTIOSIS IN THE EYE IN CHILD (CLINICAL CASE)
Khamraeva L.S., Bobokha L.Y., Abdurakhmanova C.K., Kalankhodzhaeva D.B., Makhmudova Z.A.
Abstract
A clinical case of observation of patient B-go K., was presented, 9 years old with the main diagnosis: OU-spastic eversion of the eyelids. OS-purulent corneal ulcer. Shortening ofthe upper eyelid and upper arch of the conjunctival cavity; concomitant diagnosis: vulgar ichthyosis. From the side of theeye changes were associated with hyperkeratosis,which led to the contraction of the facial skin resulting in cicatrical eversion of eyelids, xerosis, leading to abscess and ulcer of the cornea. As a result of the complex treatment (antibacterial, trophic therapy, plastic surgery of the eyelids) it was possible to achieve a positive result.
Russian Pediatric Ophthalmology. 2018;13(1):54-56
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