Vol 13, No 3 (2018)

Articles
TRANSPALPEBRAL RHEOOPHTALMOGRAPHY: FUNDAMENTALS AND RESULTS OF CLINICAL STUDIES OF MYOPIC CHILDREN
Iomdina E.N., Luzhnov P.V., Shamaev D.M., Tarutta E.P., Markossian G.A., Sianosyan A.A., Ramazanova K.A.
Abstract
Purpose. To present the fundamentals of transpalpebral rheoophtalmography development and its clinical testing on myopic children. Material and Methods. In transpalpebral rheoophtalmography development, we used our own electrophysical multilayer eye model involving the choroid and the upper eyelid, a biotechnical tetrapolar electrode system and a device for its fixation. To assess the clinical potentials of transpalpebral rheoophtalmography, we examined 128 patients aged 5-22 (ave. 13±1.1 years) with myopia of various degrees. Of these, 35 children were examined before and after functional treatment and scleroplastic surgery. Another group consisted of 70 myopic children aged 13.03±0.28 years, who were examined before and after a low-invasive sclera reinforcement procedure in which biologically active grafts were used. A comparative parallel study of transpalpebral rheoophtalmography and color Doppler ultrasonography involved 17 children (34 eyes) aged 12.5±1.8 with various clinical refractions. Results. The modeling helped assess the contribution of the eyelid blood supply into the rheographic index (which was found not to exceed 16%), demonstrated the need to replace the bipolar electrode system used in traditional rheoophtalmographyа with a tetrapolar system which provides more complete data on pulse blood filling of the choroid and ensures optimal positioning of the electrodes on the eyelid. A special helmet was designed to fix the electrodes and adjust their pressing force. We also developed a program for an automatic analysis of transpalpebral rheoophtalmography signals. A statistically significant rheographic index drop accompanying refraction increase was revealed. Rheographic index increased after functional and surgical treatment of myopia. transpalpebral rheoophtalmography was found to be more informative than Doppler ultrasonography when examining children with low and moderate myopia. Conclusion. The fundamental approach to the development made transpalpebral rheoophtalmography a highly informative and precise method of objective assessment of blood supply to the choroid. Transpalpebral rheoophtalmography uses low-cost equipment, is convenient, mobile, requires no contact with the eye and takes little time to be applied, which is especially important in pediatric practice. Transpalpebral rheoophtalmography may be used to produce new data on the pathogenesis of eye diseases, to ensure their early diagnosis and monitoring, and to assess the effectiveness of treatment.
Russian Pediatric Ophthalmology. 2018;13(3):118-124
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CHARACTERISTICS OF THE CLINICAL PICTURE AND RESULTS OF TREATMENT OF GLAUCOMA, COMBINED WITH MICROSPHEROPHAKIA IN CHILDREN
Mazanova E.V., Katargina L.A.
Abstract
Purpose. To study the clinical-functional features of glaucoma, combined with a rare genetic condition - microspherophakia. Material and methods. The analysis of complex survey 6 children (12 eyes) with glaucoma in hereditary microspheric, ranging in age from 3 months to 15 years Results. The paper highlights the characteristic anatomical and functional features of such eyes, presents variants of the clinical picture of glaucoma, depending on the timing of the debut of the glaucomatous process. The variants of step-by-step tactics of treatment of such patients are offered. The trends of the postoperative period, the tendency to the development of complications in the postoperative period, which must be taken into account both in the formulation of the correct diagnosis and the assessment of the prognosis of this pathology and the choice of tactics of treatment and further monitoring of such children. Summary. 1. The clinical picture of glaucoma associated with disorders of the lens - microspherophakia, varies widely and depends on the time of onset of the glaucoma, its degree of goniodysgenesis, condition and position of the lens. 2. The choice of adequate pathogenetically oriented tactics of surgical treatment should be carried out in each case individually. The priority is the method of normalizing IOP.
Russian Pediatric Ophthalmology. 2018;13(3):125-128
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OCULAR PROSTHETICS IN REHABILITATION OF PATIENTS AFTER SEVERE TRAUMA AND SUBATROPHY EYEBALL
Filatova I.A., Verigo E.N., Mohammad I.M., Denisjuk V.O.
Abstract
Purpose. To determine the indications for eye prosthetics in subatrophy and a comparative assessment of its results with anophthalmos after enucleation and evisceration. Material and methods. The article deals with the idea of the possibility of increasing cosmetic indicators when using ocular prosthetics and contact lenses after severe trauma and subatrophy. Results. The results of ocular prothetics in post-traumatic subatrophy (with 210 patients taking part in the experiment) are presented; prescriptions for applying such methods of rehabilitation are given. It was proved that the use of an eye prosthesis without following strict rules and medical prescriptions in the period of post-traumatic pathology could lead to an aggravation of uveitis, progression of the process, worsening of its prognosis and outcome. A comparative characterization of two groups of patients was carried out to estimate the cosmetic parameters of prosthetics: I - anophthalmos (150 cases) after enucleation with the formation of a musculoskeletal stump by orbital implants (carbotextim or polytetrafluoroethylene); II - anophthalmos (200 cases) after evisceration with resection of the posterior pole, nevrectomy and plastic stump with the same implants. Summary. During the evisceration the achieved results were close to the main experimental group when instrumental and subjective indicators were estimated. This fact gives proof to the fact that this surgical procedure is far more efficient in comparison with enucleation.
Russian Pediatric Ophthalmology. 2018;13(3):129-134
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THE FEATURES OF DIAGNOSIS AND TREATMENT OF GLAUCOMA DURING PREGNANCY
Kiseleva O.A., Yakubova L.V., Kosakyan S.M., Vasilenkova L.V.
Abstract
One of the important and completely unresolved issues of ophthalmology is the diagnosis and treatment of primary and secondary glaucoma in women during pregnancy and in the postpartum period. In the modern world more women give birth in adulthood, when pregnancy can be associated with an increased risk of the development and progression of glaucoma. The combination of glaucoma and pregnancy is a rare clinical situation and even less often glaucoma is detected during pregnancy. In childbearing age, the children’s and youthful form of glaucoma prevails among women, and may also be secondary, as a complication of other eye and systemic diseases. The IOP-reducing effect of pregnancy can mask glaucoma, that not diagnosed before it. The treatment of glaucoma of women during the pregnancy is still an unresolved problem due to fears of toxic effects, teratogenicity and side effects of drugs on the fetus, as well as on the course of the pregnancy itself. The study of the medicinal influence on the course of pregnancy is a difficult object, because there are not enough clinical cases due to a small number of patients. Influence of antihypertensive drugs in pregnant animals can not be an absolute confirmation of the safety of their use in humans. Therefore, a woman should be warned about the need for pregnancy planning and timely discussion of her management with a doctor. The review discusses diagnostic methods, the possibility of conservative, laser and surgical treatment of glaucoma during pregnancy in women.
Russian Pediatric Ophthalmology. 2018;13(3):135-142
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PERIPHERAL REFRACTION AND MYOPIA PROGRESSION
Milash S.V.
Abstract
The hypothesis of possible connection between the development of myopia and peripheral refraction determines high interest to thorough examination of peripheral defocus and the influence of different means of correction on it. Experimental and clinical data, showing the important role of peripheral refraction in the regulation of eye growth, are collected in this review. The review proves that optical strategies of myopia correction with possible induction of peripheral myopic defocus are more effective in myopia progression prevention compared to single vision spectacle lenses and contact lenses.
Russian Pediatric Ophthalmology. 2018;13(3):143-148
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NEROEV V. V., ARESTOVA N. N. LASER RECONSTRUCTIVE SURGERY FOR DISEASES OF THE EYE IN CHILDREN. MOSCOW, 2018: PUBL.RAS. 304S. 300 COPIES
Katargina L.A.
Abstract
Russian Pediatric Ophthalmology. 2018;13(3):149-149
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