Russian Pediatric Ophthalmology

BACKGROUND: Micropulse diode laser transscleral cyclophotocoagulation (MP-TSCPC) is a highly promising non-invasive alternative to surgical treatment and is increasingly used in adult patients with glaucoma. No studies have been conducted on the use of this procedure in different forms of congenital glaucoma in children.

AIM: To evaluate the efficacy and safety of MP-TSCPC in children with congenital glaucoma.

METHODS: A total of 24 MP-TSCPC procedures were performed on 22 eyes of 19 children. A Cyclo G6 glaucoma laser system (IRIDEX, USA) with infrared diode laser settings of 2000–2400 mW was used.

RESULTS: The mean follow-up period was 8.9 ± 7.2 months (2–24 months). At 3 months after treatment initiation, intraocular pressure was controlled in 88% of cases; at 6 months, in 60.9%; at 12 months, in 49.0%; and at 18 months, in 38.7%. The mean number of topical antiglaucoma medications before and after MP-TSCPC did not change significantly, being 3.1 ± 0.22 and 2.8 ± 0.42 (p > 0.1), respectively. Complications after MP-TSCPC were identified in 4 cases (16.7%). No severe complications leading to significant visual acuity loss or anatomical loss of the eye were observed.

CONCLUSION: MP-TSCPC is a minimally traumatic, highly effective, individually dosed, non-invasive hypotensive treatment for different forms of congenital glaucoma at any stage.

Leber hereditary optic neuropathy is a hereditary disorder that occurs in 90%–95% of cases due to a mutation in mitochondrial DNA. Recent publications have described an autosomal recessive form of Leber hereditary optic neuropathy caused by biallelic mutations in the nuclear DNAJC30 gene. This autosomal recessive form presents a significant clinical and diagnostic challenge due to its rarity, the lack of clear phenotypic differences from the mitochondrial form, the difficulty of interpreting instrumental findings, and the long time required for diagnosis verification. Therefore, each described case is important for better understanding of the disease course, diagnosis, and potential therapeutic approaches, which necessitates the publication of this clinical observation.

The article presents a clinical case of an autosomal recessive form of Leber hereditary optic neuropathy. Patient A., 14 years old, presented to an ophthalmologist with complaints of a sharp painless decrease in vision in both eyes. A comprehensive ophthalmological examination revealed structural changes in the optic discs and retina characteristic of Leber hereditary optic neuropathy, confirmed by ophthalmoscopy and optical coherence tomography. The key step was molecular genetic testing, which identified a homozygous mutation in the DNAJC30 gene, establishing the diagnosis of autosomal recessive Leber hereditary optic neuropathy. With regular long-term administration of antioxidant, metabolic (including idebenone), and neurotropic therapy, a significant subjective and objective improvement in visual acuity was observed, despite persistent pronounced structural changes.

This clinical case demonstrates that thorough genetic testing, including analysis of the DNAJC30 gene, is necessary in patients with clinical manifestations of this disease, especially in the absence of typical mitochondrial mutations. The observation confirms that the autosomal recessive form of Leber hereditary optic neuropathy, despite severe baseline structural damage, may respond positively to comprehensive metabolic therapy, highlighting the importance of early initiation. However, given the single-case nature of this observation, the findings on treatment efficacy require further experience and confirmation in larger studies. This report expands the understanding of the clinical picture and potential therapeutic options for this rare form of the disease.

Dry eye syndrome is a multifactorial disease that develops as a result of a decrease in the volume or deterioration in the composition of the tear fluid, which forms the tear film on the surface of the eye. It is accompanied by sensations of dryness, burning, foreign-body sensation, and reduced visual comfort.

This article aims to examine the prevalence dynamics of dry eye syndrome in the Republic of Ingushetia as one of the most common eye disorders characterized by instability of the tear film and damage to the surface of the cornea and conjunctiva.

This review draws on data from international and Russian publications on this syndrome and includes studies identifying cases of dry eye syndrome using modern diagnostic methods—the Schirmer test, tear film break-up time measurement, and biomicroscopy—conducted at the Nazran Polyclinic between 2023 and 2025. The evidence indicates that the incidence of dry eye syndrome in the Republic of Ingushetia is steadily increasing due to increasing visual strain, the use of digital devices, and adverse environmental factors. The importance of prevention, regular examinations, and the use of lubricating agents to maintain the health of the ocular surface is emphasized.

The prevalence of dry eye syndrome is increasing; therefore, early diagnosis and individualized therapy can help restore tear film stability, prevent complications, and improve patients’ quality of life.