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Vol 13, No 4 (2018)

Articles
LATE COMPLICATIONS UNFAVORABLE RESULTS OF CICATRICAL RETINOPATHY OF PREMATURITY
Kogoleva L.V., Katargina L.A., Arestova N.N., Mazanova E.V., Sudovskaya T.V.
Abstract
Purpose. The study of the frequency and structure of complications in IV-V degree of retinopathy of prematurity and the development of tactics for their prevention and treatment. Material and methods. A total of 134 patients (268 eyes) with IV-V degree of cicatricial retinopathy of premature infants aged 6 months - 17 years were examined. In addition to the standard ophthalmological examination, ultrasound methods were used: biometrics, echography, biomicroscopy. Results. Late complications were detected on 153 (57,1%) from 268 eyes with IV-V degrees of cicatrical ROP. The main types of complications were: flat anterior chamber, corneal and lens opacities, secondary glaucoma, progressive phthisis bulbi. Conclusions. All patients with cicatricial ROP require constant follow-up and differentiated tactics of prevention and treatment of late complications.
Russian Pediatric Ophthalmology. 2018;13(4):158-161
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REHABILITATION POSSIBILITIES OF SOFT CONTACT CORRECTION IN POST-TRAUMATIC AND CONGENITAL PATHOLOGY OF CHILDREN
Neroev V.V., Verigo E.N., Selina O.M.
Abstract
Objective. To analyze the results of the use of contact correction in the rehabilitation of children with post-traumatic and congenital abnormalities. Material and methods. 424 patients, aged between 3 months and 17 years, using soft contact lenses using traditional and special methods of examination. Results and discussion. It was established that in the overwhelming number of children who were assigned to wear, the post-traumatic pathology prevailed - 341 (79.1%) patients; congenital abnormality was 83 cases (20.9%). Contact lenses were made individually according to the developed technologies from a hydrogel material by turning using biocompatible paint, which allows combining several color zones of different diameters, while achieving optimal functional and cosmetic results. Proved a significant increase in visual acuity compared with spectacle correction and correction of transparent contact lenses in 86.4% of children. Thus, the use of soft contact lenses, performing corrective, diaphragmatic and cosmetic function is a method of preventing the development of amblyopia, strabismus, contributing to the full development of the visual analyzer in children.
Russian Pediatric Ophthalmology. 2018;13(4):162-166
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MACULOPATHY AND CHORIORETINOPATHY IN CHILDREN WITH RETINOBLASTOMA RECEIVING CHEMOTHERAPY: CLINICAL TRIALS AND MORPHOMETRIC ANALYSIS
Saakyan S.V., Myakoshina E.В., Polyakov V.G., Ushakova T.L., Ismailova D.M.
Abstract
Purpose. This research is to evaluate patients with retinoblastoma, who receive chemotherapy, with Spectralis optical coherence tomography with enhanced depth imaging to compare the signs of chorioretinopathy and maculopathy. Material and methods. 74 patients were examined and treated, 125 eyes with retinoblastoma in age at average of 24 ± 1.6 months. Group 1 - 31 patients, 62 eyes after intravenous chemotherapy, 2 - 24 patients, 25 eyes after intravenous and superselective intraarterial or intravitreal chemotherapy. Group 3 (control) - 19 patients (38 eyes) with primary retinoblastoma. The condition of the retina, choroid and macula was assessed using Ret Cam II and Spectralis optical coherence tomography with enhanced depth imaging. All patients had complete tumor resorption after treatment. Results. In group 1, after 3 courses of chemotherapy Spectralis optical coherence tomography with enhanced depth imaging showed a decrease of caliber of retinal vessels; wavelength of photoreceptors, hyperreflective round foci and calcinates in the retinal pigment epithelium; choriocapillary hyperreflexivity, choroid thinning; in the sclera - hyperreflective foci with visualization of the scleral vessels. In the macula - disorganization of retinal pigment epithelium, cystic edema, smoothness of the papillomacular bundle, coracoid form of the fovea, retinal thickening. After 3 courses of systemic chemotherapy and superselective intraarterial chemotherapy (group 2) - peritumoral increase in the caliber of retinal vessels. After systemic superselective intraarterial and intravitreal chemotherapy (group 2) - epiretinal membranes, punctate hyperreflective foci in the inner layers of the retina. In group 3 (control), before treatment, a normal anatomical and topographic state of the macula was observed with extracentral localization of retinoblastoma. Conclusions. Profound morphometric disturbances that come with combined chemotherapy (intravenous, superselective intraarterial and intravitreal chemotherapy treatments) call for a more careful treatment with methods selected in terms of Spectralis optical coherence tomography with enhanced depth imaging findings and specific chemotherapy contraindications.
Russian Pediatric Ophthalmology. 2018;13(4):167-175
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CLINICAL-ANATOMICAL FEATURES OF CONGENITAL ANOPHTHALMUS IN CHILDREN
Sudovskaya T.V., Kogoleva L.V., Utkina O.A.
Abstract
Purpose. to study the clinical and anatomical features of congenital anophthalmus in children, indication and timing of prosthetic orbit. Material and methods. 17 children with congenital anophthalmus aged 1 - 6 month were examined. Routine ophthalmological examination, ultrasound diagnostic including the measurements of axial length of the rudiment of the eye, if available, and B-scan, the computed tomography (CT) scan of the orbit and cranium, immunological investigations with serological infectious disease testing were performed in all patients. Results and discussion. Based on the complex examination we determined types of congenital anophthalmus in children. The step method prosthesis for the symmetric growth of bones and orbital tissues and cosmetic rehabilitation was developed. The indications and contraindications for ocular prosthesis in children with congenital anophthalmus were identified. Findings. the step methods for ocular prosthesis in children with congenital anophthalmus is the main method. Surgical interventions in the early years of children are contraindicated.
Russian Pediatric Ophthalmology. 2018;13(4):176-179
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COMPLEX THERAPY OF INFECTIOUS CONJUNCTIVITIS, ACCOMPANIED BY AN ALLERGIC REACTION
Pozdnyakova V.V., Yani E.V., Vakhova E.S.
Abstract
Complex therapy of infectious conjunctivitis (adenovirus, herpetic, bacterial, chlamydial), complicated by toxic-allergic reaction, developing during the acute infectious process or long-term vigorous treatment, includes several treatment algorithms. The method of therapy consists in the use of systemic and local anti-allergic drugs against the background of a specific etiological antibacterial, antiviral or anti-herpetic therapy in combination with symptomatic therapy (anti-infectious, anti-inflammatory, reparative and tear replacement agents). The use of the developed algorithms of therapy can improve the effectiveness of treatment by 12-25%.
Russian Pediatric Ophthalmology. 2018;13(4):180-184
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HERPETIC BLEFAROCERATOCONJUNCYVITIS. CLINICAL CASES
Vakhova E.S.
Abstract
Purpose. Remind practitioners of the clinical picture of herpetic blepharoconjunctivitis, the clinical features of the three forms of herpetic conjunctivitis and its difference from adenoviral conjunctivitis. Material and methods. In the description of clinical cases it is shown that the rash of vesicles of herpes on the skin of the eyelids with blepharoconjunctivitis, allows to identify the etiology of the pathological process and choose the correct treatment strategy. Examines modern approaches to the treatment of herpes skin rashes and prophylactic measures for the eyes. It emphasizes the high risk of corneal damage and the development of herpetic keratitis during primary ofothalmus herpes, as well as the need for systemic and local antiherpetic therapy. Discussion. It is important to note that the alertness of the pediatric ophthalmologist in terms of detecting herpes blepharkeratoconjunctivitis, as the debut of a herpetic eye infection, is reduced. Laboratory confirmation is not always possible, which probably leads to the underdiagnosis of this disease. Conclusion. Inadequately selected therapy contributes to the further course of recurrent herpetic keratitis already in the adult patient’s age.
Russian Pediatric Ophthalmology. 2018;13(4):185-188
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HYPERTENSIVE ANGIORETINOPATHY IN A CHILD WITH PHEOCHROMOCYTOMA. CLINICAL CASE
Denisova E.V., Osipova N.A., Katargina L.A.
Abstract
Purpose: to present a clinical case of a child with hypertensive retinopathy developed against the background of undiagnosed pheochromacytoma and primarily regarded as neuroretinitis. The description of the case shows that a comprehensive examination of the child together with a pediatrician and endocrinologist allowed to identify the etiology of the pathological process and choose the right treatment strategy. Discussion. It is important to note that the alertness of the pediatric ophthalmologist in terms of the development of hypertensive retinal angiopathy is reduced. Arterial hypertension in children is much less common than in adults, and cases of hypertensive retinal lesions in children are rare. This can lead to a number of errors in the diagnosis and treatment of eye pathology, as well as underestimation of the severity of the General somatic condition of the child, in this connection it is important to emphasize the importance of close interdisciplinary cooperation in the examination and treatment of children of ophthalmic profile.
Russian Pediatric Ophthalmology. 2018;13(4):189-192
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