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Vol 16, No 2 (2021)

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Original study article

Role of studying the pathogenesis of retinopathy of prematurity in optimizing disease screening

Katargina L.A., Chesnokova N.B., Balatskaya N.V., Osipova N.A., Panova A.Y.


Background: The efficiency of treatment and prevention of retinopathy of prematurity (ROP) has improved. In addition, the development of a disease screening system to reduce the incidence of disability resulting from this pathology is important.

Aim: This study aimed to determine new laboratory criteria for screening and predicting the ROP course through in-depth investigation of the molecules participating in the pathogenesis of ROP.

Material and methods: A comprehensive clinical and experimental study was performed to assess the local and systemic levels of 49 cytokines with various biological effects, four monoamines, and angiotensin-II (AT-II) at different stages of the pathological process. In the clinical analysis, 165 preterm infants at risk of ROP development were examined. For the experimental part, the disease course of 145 Wistar infant rats in the developed model of experimental ROP was analyzed.

Results: Among cytokines, the seven most promising potential laboratory markers of ROP development and adverse course were as follows: MCP1 >95 pg/mL, IGF-II >140 pg/mL, TGFbeta1 <18000 pg/mL, and IGF-I <24 pg/mL in the blood serum of preterm infants before the first signs of ROP and VEGF-A >108 pg/mL, TGF-beta2 >100 pg/mL, and PDGF-BB >1800 pg/mL at ROP manifestation. Among monoamines, serotonin (<17.0 pg/mL) and L-DOPA indicated their prognostic value in the clinical and experimental settings. Moreover, a possible prognostic role of AT-II was found.

Conclusion: In this study, methods to improve the ROP screening system are outlined, but further work is necessary to assess the possibility of implementing the results in clinical practice

Russian Pediatric Ophthalmology. 2021;16(2):5-13
pages 5-13 views

The efficiency of congenital cataract management in children

Afanasyeva D.S., Zhadan V.A.


Aim: This study aimed to analyze the results of congenital cataract treatment in children who underwent surgery in VP Vyhodcev Eye Hospital from 2015 to 2019 and to compare these data with global results.

Material and methods: A retrospective analysis of electronic outpatient medical records of children who underwent surgery for congenital cataract during the period from 2015 to 2019 included the following parameters: age at the first admission to the Eye Hospital, delay between the first admission and cataract surgery, age at surgery, best corrected visual acuity at the end of follow-up, and presence of any eye comorbidities. To compare the obtained data with the results of similar studies worldwide, articles on this topic published during the past 5 years were searched.

Results: This retrospective study analyzed 71 electronic outpatient medical records of children with congenital cataract (96 eyes). The age at the first admission was 33.5 [60.0–81.5] months. The best corrected visual acuity before surgery was 0.2 [0.1–0.4]. The delay between the first admission and cataract surgery was 5.0 [2.5–12.0] months; thus, children underwent surgery for congenital cataract at age 51 [14.5–94.5] months. In all patients, lens aspiration with intraocular lens implantation resulted in significant improvement of visual acuity to 0.4 [0.1–0.9]. The comparative analysis revealed a trend for earlier recognition and surgical treatment of congenital cataract in European countries, while a significant delay before surgery and worse visual outcomes are common in developing countries.

Conclusion: The current state of ophthalmological care for children with congenital cataract in Russia allows achieving good visual outcomes comparable with published results in Europe. Nonetheless, further studies are required to determine reasons for later recognition and surgery of congenital cataract in children

Russian Pediatric Ophthalmology. 2021;16(2):15-22
pages 15-22 views

Clinical practice guidelines

Bacterial corneal ulcers in pediatric patients: Clinical and laboratory diagnostics. Part I

Kovaleva L.


Bacterial corneal ulcer is the second most common complication of herpetic ulcer, but it is the most severe complication and has the highest progression rate. The main causative agents of bacterial corneal ulcers are Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Neisseria gonorrhoeae. The frequency of the detection of corneal ulcers caused by gram-negative Pseudomonas aeruginosa has increased, which is characterized by a lightning-fast course and a high frequency of complications and adverse outcomes. Gonococcal corneal ulcer caused by Neisseria gonorrhoeae is less common in pediatric patients than in adult patients, but it has the most aggressive disease course, which does not change with age. Bacterial corneal ulcers are one of the main causes of corneal blindness and can lead to endophthalmitis, corneal perforation, and eye loss within a short time. Clinical differential diagnostic signs allow us to assume, with a high degree of probability, the etiology at the first biomicroscopy and immediately begin etiotropic therapy, which is crucial for the outcomes of bacterial corneal ulcer. The standard laboratory examination of patients with bacterial corneal ulcer includes bacterioscopic and culture examinations of the contents of the conjunctival sac. This paper presents an up-to-date review of publications, clinical features, differential diagnostic criteria, laboratory diagnostic methods of bacterial corneal ulcers in pediatric patients

Russian Pediatric Ophthalmology. 2021;16(2):23-30
pages 23-30 views

Conjunctivities of newborns

Saidasheva E.I., Buianovskaia S.V.


The article is focused on the peculiarities of the clinical course of separate forms of neonatal conjunctivitis, depending on the etiological factor. It was found that more often the disease refers to nosocomial eye infection and bacterial nature. We performed the bacteriological analysis of the contents of the conjunctival cavity of 50 newborn patients being treated in the neonatal department. Our analysis indicated the leading role of gram-positive bacteria — Staph. epidermidis (59.7%) and Staph. aureus (21.7%) in the development of the inflammatory process. The share of other types of pathogens, including gram-negative minor and various pathogens, is from 0.54% to 3.2%.

The cause of nosocomial infection is considered to be the pathogen that circulates in the department and acquires the features of a hospital strain. These are consistent with the results of similar studies conducted by both domestic and foreign clinicians, which are also presented in the article. Particular attention is paid to the causative agents of intrauterine infections that are dangerous for the anterior section: gonococcus, chlamydia, herpes simplex, etc. These agents often cause serious diseases in newborns (gonoblenorrhea, ophthalmic chlamydiosis, and ophthalmic herpes), in which the cornea and vision are often affected.

The article highlights the measures of primary prevention of intrapartum infection of the ocular surface in newborns, adopted in Russia. The paper presents modern approaches to selecting drugs for local antibacterial therapy of neonatal conjunctivitis, considering age restrictions for their use. Methods of laboratory diagnostics and their validity for the etiology of conjunctivitis have been described in detail. For example, the bacteriological method (inoculations in various culture media) is considered a reference (specificity 100%). The culture medium can be used to isolate bacteria, chlamydia, and mycoplasma, which allows getting clear results even with a minimal amount of microflora

Russian Pediatric Ophthalmology. 2021;16(2):31-39
pages 31-39 views

Case reports

Bilateral neurorethinovasculitis associated with COVID-19 infection in a girl 17 years old

Denisova E., Demchenko E.N., Geraskina E.A., Khrabrova M.A., Panova A.Y.


Despite dominant lung lesions, new coronavirus infection (COVID-19) can influence almost any organ, including eyes. According to modern data, frequency of eye damage by COVID-19 reaches 32%, and spectrum of clinical manifestations is diverse. Changes are observed both in the anterior (mainly conjunctivitis) and posterior (mostly retinal vascular thrombosis, optic neuritis, neuroretinitis) segments of the eye, and the timing of their occurrence varies from the first (sometimes the only) clinical symptoms of the disease to the development at the peak or during the period of convalescence from COVID-19.

In children symptomatic COVID-19 infection is diagnosed less frequently than in adults, and ophthalmic manifestations are less investigated. This article describes a case of bilateral neuroretinovasculitis in a 17-year-old girl with a mild course of COVID-19, that arose 3 weeks after the onset of the disease, which broadens the understanding of ocular manifestations of COVID-19 in children.

We emphasize that an ophthalmologist should know ocular manifestations of COVID-19, which can help in the diagnosis and further study of the frequency and spectrum of ophthalmic symptoms, especially in children

Russian Pediatric Ophthalmology. 2021;16(2):41-52
pages 41-52 views


Nystagmus: prevalence, classification, pathogenesis. (Literature review)

Apaev A.V.


The article provides information on the prevalence of nystagmus in the Russian Federation and the world. However, the lack of standards for data collection and the very understanding of the definition of “optical nystagmus” is the reason for the variation in prevalence values in different sources.

Additionally, the article presents various classifications of nystagmus. Currently, there are many different classifications, and the most commonly used examples are given. The classification of eye movement disorders and strabismus, adopted by the working group in 2001 (Classification of Eye Movement Abnormalities and Strabismus — CEMAS), is used worldwide. In our country, the most popular was the classification proposed by E.S. Avetisov (2001).

Various sources have suggested quite contradictory data on the nature of the onset and the mechanism of development of nystagmus. Recently, the issues related to the pathogenesis of nystagmus have been revised. The theories that existed at the end of the last century were not substantiated in modern works. The pathogenesis of optic nystagmus remains less studied due to its complexity and ambiguity. The investigations continue to find the relationship between the pathology of the central nervous system and functional disorders of visual functions. The question of the relationship between visual acuity and nystagmus remains unclear. Does a decrease in vision cause nystagmus? How do oscillatory movements in nystagmus affect visual functions? This article encompasses the main areas of this issue. However, despite a significant step in understanding the causes of the development of nystagmus, this pathology remains insufficiently studied. This prompts many researchers and practicing doctors to study its pathogenesis further

Russian Pediatric Ophthalmology. 2021;16(2):53-60
pages 53-60 views

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