Vol 10, No 4 (2015)


The results of the treatment of refractive amblyopia with the help of the “Amblyocation” computer program

Bikbov M.M., Zainutdinova G.K., Kudoyarova K.I., Luk’yanova E.E., Kampf U.


The present study included 12 children at the age from 6 to 9 (mean 8,7 ± 1,14) years presenting with refractive amblyopia of differing severity who were treated with the use of the“Amblyocation” computer program (U. Kampf and co-workers, 1995). We evaluated the acuity of vision before and after correction as well as the spatial contrast sensitivity to red, green, blue, and white colours. The analysis of the data obtained has demonstrated a various degree of the improvement of both corrected and uncorrected visual acuity while spatial contrast sensitivity to green colourimproved in all the patients, to red colour in 90% of them, to white and blue colours in 91.6% and 58.3% respectively. It is concluded that the proposed “Amblyocation” system for the eye exercises can be effectively used as an additional tool for the treatment of children presenting with refractive amblyopia of different severity. One of the advantages of this program is the possibility of treatment at home via the Internet with the use of the computer-based program and the interactive platform allowing to control and document the compliance of the patients with the physician’s prescriptions.
Russian Pediatric Ophthalmology. 2015;10(4):5-7
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The influence of the complete correction of refractive anomalieson the outcome of the treatment of esotropia in the children at the age of up to 3 years

Kasimov E.M., Gadzhieva N.R.


The objective of the present study was to estimate the effectiveness of the treatment of esotropia in the children. The study involved 231 children at the age of up to 3 years presenting with esotropiaincluding those with hypermetropia (n = 21, 9,1%), hypermetropic astigmatism (n = 135, 58.4%), mixed astigmatism (n = 26, 11,3%), and mild ametropia (n = 49, 21,2%). Examination of the patients was followed by the complete correction of the spherical and cylindrical components designed to reduce astigmatism down to 0.5 Dptr. The correction was aimed not only to improveaccommodation but also to maximally enhance the acuity of vision to ensure a clear image on the retina of both eyes. The children were re-examined 1.6 and 12 months after the initiation of the study. The age at which strabismus became manifest varied from 3 to 35 (mean 10.73 ± 10) months and the mean age at which the spectacles were prescribed varied from 3 to 36 (mean 21,93 ± 11) months. The angle of deviation estimated by the Hirshchberg test varied from 5 to 60 degrees. 138 (59,7%) and 93 (40,3%) children presented with infantile and acquired esotropia respectively. The eye alignment was achieved in 178 (77,1%) children and reduction of the angle of deviation in 27 (11,7%) ones within 12 months after the onset of the treatment. Strabismus remained uncorrected in 26 (11,3%) children. The best results of the treatment were obtained in the children with a shorter period between the appearance of strabismus andthe prescription of the spectacles (p< 0,001). It is concluded that the complete correction designed to bring to a minimum the changes of refraction between the two eyes (reduce astigmatism down to 0,5 Dptr) immediately after theappearance of strabismus effectivelypromotes alignment of the eyes in the overwhelming majority of the children provided the medical assistance was sought in due time. The identification number of the trial NCT01404324 at Clinicaltrials.gov.
Russian Pediatric Ophthalmology. 2015;10(4):8-11
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Laser anterior vitreolysis in the children presenting with pseudophakia following extraction of congenital cataracts

Katargina L.A., Arestova N.N., Egiyan N.S., Kalinichenko R.V.


This article was designed to report of the analysis of the changes in the anterior layers of the vitreous body revealed during YAG laser-assisted ablation of secondary cataracts in 34 eyes of the children presenting with pseudophakia following extraction of congenital cataracts. The study has demonstrated clinical variants of congenital and postoperative opacity of the anterior layers of the vitreous body. The strategy and optimal energy parameters of the effective laser vitreolysis are proposed together with the rationale for the combined sequential (one-step) application of YAG laser destruction of secondary cataract and anterior vitreolysis of the revealed opacity.
Russian Pediatric Ophthalmology. 2015;10(4):12-15
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The role of the systemic disbalance of serum cytokine levels in pathogenesis of retinopathy of prematurity

Katargina L.A., Slepova O.S., Demchenko E.N., Osipova N.A.


The present study of the systemic disbalance of the serum cytokine levels included 80 prematurely born children before they developed clinical manifestations of retinopathy of prematurity (ROP). The analysis of the relationship between the characteristics of the cytokine status and the development of ROPduring the subsequent period was undertaken. It was shown that the frequency of detection of cytokines and their concentration in the blood serumof the premature infants are subject to broad variations. The study revealed the tendency toward the prevalence of potentially “pathogenic” (angiogenic, proinflammatory) cytokines in the sera of the premature children who later developed the “threshold” stage of ROPwhich dictated the necessity of laser coagulation of the avascular retinal regions. Of special interest are the observations of serum IGF-II and TGF-beta levels. The former of these parameters showed the fairly well-apparent tendency toward increase in the group of the children with the “threshold” stage of ROP while the letter tended to decrease. It is concluded that the further investigations into the relationship ofserum IGF-II and TGF-beta levelswith those of VEGF at different stages of ROP evolution have good prospects.
Russian Pediatric Ophthalmology. 2015;10(4):16-19
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The prevalence of heterophoria among the schoolchildren with different clinical refractive errors

Prediger V.M.


This article presents the results of the study that involved153 schoolchildren at the age from 8 to 16 (mean 10,5) years presenting with different forms of phoria. The ophthalmological examination included thein-depth investigation of phorias. The study has demonstrated the predominance of exophoriaassociated with emmetropia, mild hypermetropia and myopia. 40% of the patients presented with 1-5 Dptrexophoriaand 8,5% withexophoriaover 5 Dptr. Esophoria was widespread among the myopic children. Specifically, its prevalence among the patientswith mild myopia was estimated to be 39% while it occurred in 35% of the children having moderate myopia. The study revealed the marked influence of the correction with the use of the spectacles on the position of the optical axes in the myopic children manifest as the reduction of exophoria down to the physiological level and the increase in esophoriaby 1-3 Dptr in 92% of the children. The difference was statistically significant (p < 0,01).
Russian Pediatric Ophthalmology. 2015;10(4):20-21
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The application of optical coherent tomographyfor differential diagnostics of small retinoblastomas and “pseudoretinoblastomas” in the children

Saakyan S.V., Myakoshina E.B., Denisova E.V.


This article describes the characteristic early features of different forms of retinoblastomasof significance for their differential diagnostics. The study included 47 children presenting with small retinoblastomas (83 eyes, 105 tumours), inflammatory granuloma (31 children, 31 foci), and retinal astrocytic hamartoma (11 children, 11 foci). The method of optical coherent tomography was applied for the purpose of tumour identification. It was shown that the data thus obtained in the combination with clinical observations make it possible to diagnose malignant retinal tumours in the children at the early stages of their development and thereby to prescribe the timely adequate treatment.
Russian Pediatric Ophthalmology. 2015;10(4):22-25
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The clinical picture, diagnostics, and treatment of ophthalmological paraneoplastic syndromes

Boginskaya O.A., Pershin B.S., Smirnova A.B.


Ophthalmological paraneoplastic syndromes are the extremely rare pathological conditions that affect the eye and its accessory structures due to the distant influence of the tumour. The clinical and diagnostic signs in the majority of the cases of paraneoplastic neuropathies and neuro-ophthalmological disorders are not specific and may reflect the presence of many otherpathologies. The phenotypic expression of the clinical manifestations is highly variable and depends on the immunological profile of the antigens involved in the pathological process. Thus far, there are neither-generally accepted diagnostic criteria for the ophthalmological paraneoplastic syndromes nor therapeutic modalitiesfor their management which dictates the necessity of thefurther investigations and multi-center studies in this field.
Russian Pediatric Ophthalmology. 2015;10(4):26-31
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The biomechanical aspects of keratorefractivesurgery and corneal cross-linking

Iomdina E.N.


The present analytical review concerns the relationship between the biomechanical characteristics of the cornea, the safety and effectiveness of keratorefractive surgical interventions, and the development of keratectasias of different origin, in the first place formation of the keratoconus. The modern methods for the diagnostics of biomechanical lesions of the cornea and the approaches to their correction are described.
Russian Pediatric Ophthalmology. 2015;10(4):32-37
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Rehabilitation of the children following extraction of congenital cataracts

Katargina L.A., Kruglova T.B., Egiyan N.S., Trifonova O.B.


The modern microsurgical technologies with the use of viskoprotection and elastic intraocular lenses make possible the surgical treatment of congenital cataracts based on the novel qualitative approaches. However, notwithstanding the great progress in microsurgery, the treatment of congenital cataracts and medical rehabilitation of the children presenting with this condition still remain a serious challenge. An objective of rehabilitative medicine is the organization of the rehabilitation process during the reconvalescenceperiod with the application of the specialized diagnostic and physiotherapeutic methods. The modern concept of medical rehabilitation of the children after extraction of congenital cataract has been formulated based on the summation of the experience accumulated at the Department of Pathology of the Helmholtz Moscow Research Institute of Eye Diseases.
Russian Pediatric Ophthalmology. 2015;10(4):38-42
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The VIII Russian National Ophthalmological Forum-201 (22-24 September 2015, Moscow)

Arestova N.N.
Russian Pediatric Ophthalmology. 2015;10(4):54-55
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