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Vol 15, No 3 (2020)

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Clinical studies

Potential of two-channel rheoophthalmography in the assessment of ocular blood flow in children and adolescents with myopia

Iomdina E.N., Kushnarevich N.Y., Larina T.Y., Tarutta E.P., Luzhnov P.V., Kiseleva A.A.


Aim. This study aimed to investigate the diagnostic potential of two-channel rheoophthalmography (ROG) in the assessment of ocular blood flow disorders in children and adolescents with myopia.

Material and methods. The method developed allowed one of the ROG channels to probe deep into the posterior pole of the eye and was designed to assess blood supply in the eye pole. Furthermore, the other channel was used to analyze blood flow in the temporal arteries — in the area of the ophthalmic and internal carotid arteries. Both signals were recorded simultaneously, which allows measuring of the blood flow distribution between these vascular regions. To assess the diagnostic potential of the method, two-channel rheoophthalmography signals were recorded and analyzed. The signals were obtained from 24 eyes (13 patients): 13 eyes (7 patients; median age, 14.1 years) with low myopia (−0.5 to −3.0 D) and 11 eyes (6 patients; median age, 23.7 years) with emmetropia (control group).

Results. In myopia patients, a relative increase of 4.1% in the ocular channel rheographic index (RI) was detected, whereas in the temporal channel, the RI increased simultaneously by 4.97%. The basic impedance (BI) indicator, obtained using the same method, increased by 22.4% in the ocular channel and by 29.5% in the temporal channel.

Conclusion. The simultaneous increase in BI in the temporal region and posterior eye pole area and proportional increase in pulse blood filling (RI) indicate that a change in blood supply in the posterior eye pole could be observed even in low myopia patients.

Russian Pediatric Ophthalmology. 2020;15(3):5-10
pages 5-10 views

Frequency of myopia development after congenital cataract extraction in infancy with different keratometric and biometric parameters in pseudophakic eyes

Kruglova T.B., Egiyan N.S., Mamykina A.S., Katargina L.A.


Aim. In most children, unplanned myopia develops after the extraction of congenital cataracts (CC) with t he implantation of intraocular lenses (IOLs) in infancy; thus, it is necessary to analyze the mechanisms of its development.

The study aimed to investigate the role of keratometric and biometric indicators of eyes in pediatric patients with pseudophakia in the formation of myopia.

Material and methods. Analysis of refraction indices, degree of postoperative astigmatism, and length of the anteroposterior axis (APO) was performed in 40 pediatric patients (56 eyes) with bilateral (29 children, 45 eyes) and unilateral (11 children) pseudophakia at the age of 4 to 8 years after CC extraction with IOL implantation in infancy.

Results. Myopia was detected in 67.9% (38 eyes, 28 children) of cases, including 41.1% (23 eyes, 16 children) with moderate (12 eyes) and high (11 eyes) myopia. The study revealed a direct average correlation between the magnitude of astigmatism and the degree of developing myopia. Astigmatism of >3.25 diopters was detected frequently in moderate and high myopia. For eyes with astigmatism of >3.25 diopters, the APO length was 22.6 ± 1.9 mm (21.8–23.5 mm), whereas for those with astigmatism of <3.0 diopters, it was 20.9 ± 1.8 mm (20.3–21.5 mm). With the initial APO length of <20.0 mm, less eye growth was registered in the postoperative period.

Conclusion. In the majority of pediatric patients with pseudophakia, myopic refraction develops after CC extraction in infancy, which is influenced by the degree of astigmatism and the initial values of the APO length. Astigmatism of >3.0 diopters causes irregular peripheral defocus on the retina, which contributes to the overgrowth of the eye with pseudophakia after early CC extraction, leading to axial myopia. In CC eyes, the risk of myopia is lower with an initial APO length of <20.0 mm.

Russian Pediatric Ophthalmology. 2020;15(3):11-16
pages 11-16 views

Results of corneal collagen crosslinking in children and adolescents with keratoconus I-III stage

Shefer K.K., Mirsaitova D.R., Titov A.V.


Aim. To estimate effectiveness and results of Corneal collagen crosslinking keratoconus treatment in children in a year after the treatment.

Material and methods. 15 patients (21 eyes ) aged 11-18 with keratoconus I-III st. were studied before the CXL and a year after the surgery. We compared their data of standart ophthalmological and deep keratotopographic investigations, included best corrected and uncorrected VA, keratometry, pachimetry, refraction, corneal OCT e.t.c.

Results. No intra- or postoperative complications were observed. In a year after CXL we found statistically significant improve in VA (uncorrected and best corrected) in children, stability and improvement of corneal characteristics as decrease in SE of myopia and stabilization of all topographic indices.

Conclusion. CXL is a safe and effective method for the stabilization of progressive keratoconus in children. It halted disease and improves corneal topography and visual functions in children and adolescents. But we should manage such patients very carefully as keratoconus in children tends to be more aggressive and unpredictable in its progression.

Russian Pediatric Ophthalmology. 2020;15(3):17-22
pages 17-22 views

Clinical recomendations

Prevention of myopia in schools

Katargina L.A., Tarutta E.P., Tarasova N.A., Kushnarevich N.Y.


This manual is intended for ophthalmologists, pediatricians, general practitioners, instructors, and methodologists in physical therapy and hygiene education and describes health standards and physical exercises for the prevention of myopia and its progression in schools.

Russian Pediatric Ophthalmology. 2020;15(3):23-27
pages 23-27 views


The state of the visual sensory system in multiple sclerosis

Saidasheva E.I., Boiko E.V., Buyanovskaya S.V.


The article presents a review of publications on the changes in the visual field analyzer in multiple sclerosis.

Russian Pediatric Ophthalmology. 2020;15(3):28-36
pages 28-36 views

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