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Vol 17, No 2 (2022)

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Original study article

Аdaptation and quality of vision in glasses with lenses for the control of stellest myopia with built-in high-spherical microlenses

Proskurina O.V., Tarasova N.A., Markosyan G.A., Arutyunyan S.G., Milash S.V., Tarutta E.P.


AIM: Evaluate the visual adaptation and vision quality of glasses with Stellest lenses.

MATERIAL AND METHODS: A total of 35 children aged 8–13 years (average: 10.5±0.27 years) with mild and moderate myopia (average: 3.15±0.19 dpt) in glasses with Stellest lenses and 30 children aged 8–13 years (average: 10.4±0.3 years) with mild and moderate myopia (average: 2.66±0.2 dpt) in monofocal glasses as the control group. Refraction and visual acuity (OS) were assessed after the appointment of glasses. Ergonomic tests were conducted 3–4 months after the children started wearing them. At 3–4 weeks after they started wearing glasses, all patients filled out a questionnaire of 8 questions.

RESULTS: The monocular distance in the Stellest glasses averaged 1.17±0.02, and the specific values were 1.24±0.03 for binoculars, 1.09±0.02 for monofocal glasses, and 1.160.02 for binocular glasses. Near monocular OZ in Stellest glasses averaged 0.95±0.01 and 0.96±0.01 for binocular glasses; the values were 0.96±0.01 and 0.97±0.01 for monofocal glasses. The minimum mesopic contrast sensitivity in Stellest glasses was 3.76±0.04 (with a reference value of 4) and 3.44±0.1 in the trial frame (p <0.05). In the conditions of the glare effect, the values of 7.47±0.08 for the Stellest glasses (with a reference value of 8) and 6.76±0.2 for monofocal glasses were observed (p <0.01). In monofocal glasses, the corresponding indicators were 3.71±0.09 and 7.2±0.14. Under the conditions of the gler effect, the indicator was 0.84 higher than that of the trial frame (p <0.01). The tendency to lower ergonomic indicators in Stellest glasses has been revealed. The subjective assessment of the quality of vision was high in both groups

CONCLUSION: A preliminary assessment revealed highly functional and ergonomic performance and good portability of glasses with Stellest lenses.

Russian Pediatric Ophthalmology. 2022;17(2):5-12
pages 5-12 views

Clinical and functional indicators of the eyes in children with pseudophakia and their mothers

Khamraeva L.S., Kruglovа T.B., Narzullaeva D.U.


AIM: To analyze clinicofunctional and echobiometric indicators of the eyes in children with target refraction, pseudofacial myopia, and their mothers.

MATERIAL AND METHODS: In the eye department of the clinic of the Tashkent Pediatric Medical Institute, a correlation analysis of optical and echobiometric indicators was conducted in 30 children (30 eyes) with artifakia and their mothers (60 eyes). Visiometry, keratorefractometry, and ultrasound examination (A/B scan of the eyeball) were conducted. Children were examined 12–14 months after CC extraction with intraocular lens (IOL) implantation.

RESULTS: A strong direct correlation was determined between the optical power of IOLs in children and their mothers who were theoretically planned for IOL implantation of IOLs in the group that has achieved target refraction. This may indicate the possibility that the child has the same optical power as the mother and the optical power of IOLs in a child is the same as that in adults. No correlation was found between the optical power of the IOL in the eyes of children with pseudophakic myopia and maternal artificial lenses theoretically planned for implantation.

CONCLUSION: The direct strong correlations between the optical power of the IOL of children and the lenses of their mothers in the group with the target refraction achieved by this age make it possible to use the optical power of maternal lenses as a “guideline” when calculating the power of the IOL implanted in children to achieve the target refraction. The lack of correlation between the refractive powers of the IOL in children with pseudophakic myopia and the lenses of mothers may indicate that the SRK II formula with age-related hypocorrection is not adapted to calculate the IOL power in children at risk of excessive refractive enhancement after surgery.

Russian Pediatric Ophthalmology. 2022;17(2):13-19
pages 13-19 views

Clinical practice guidelines

Structure of iris neoplasms in children and adolescents

Saakyan S.V., Svirina I.V., Tsygankov A.J., Myakoshina E.B., Kiseleva T.N., Lugovkina K.V.


AIM: To describe clinical cases of iris neoplasms in children and adolescents.

MATERIAL AND METHODS: The study was based on retrospective and prospective analyses of children and adolescents with iris neoplasia from January 2018 to April 2022. During this period, 44 children with suspected iris neoplasia, including 20 boys and 24 girls, applied to the outpatient department; their ages ranged from 6 months to 17 years (9.1±5 years). The diagnosis was based on a comprehensive examination of patients including clinical and instrumental methods. Biomicroscopy, ultrasound investigation including ultrasound biomicroscopy, and when necessary, optical coherence tomography of the anterior eye region were performed. When it was impossible to establish the diagnosis due to the child’s age, the examination was performed under general anesthesia in the ocular oncology and radiology department.

RESULTS: Of the 44 iris lesions, nevus was found in 32 (72.7%) patients, iris melanosis in 3 (6.8%), cysts in 5 (11.3%), heterochromia in 1 (2.3%), floccula in 1 (2.3%), hamartroma in 1 (2,3%), and melanocytoma in1 (2,3%). The majority of the patients with these lesions are observed in the outpatient department. From January 2018 to April 2022, six children with iris lesions were examined in the department of ophthalmo-oncology and radiology under general anesthesia; accordingly, two children received dynamic observation, two underwent iridectomy, and two others underwent YAG-laser cystotomy and cystodestruction. Two iridectomies were also performed among adolescents. Histological diagnosis was verified in four patients after iridectomy: iris stromal cyst, iris pigment epithelium cyst, melanocytoma, and iris spindle cell nevi were detected.

CONCLUSION: According to the observation data, iris nevi were most common (72.7%), followed by cysts (11.3%) and melanosis (6.8%) of the iris. Heterochromia, floccules, and hamartomas, and melanocytoma of the iris had equal frequency (2.3%).

Russian Pediatric Ophthalmology. 2022;17(2):21-30
pages 21-30 views

Case reports

Chronic unilateral anterior nodular scleritis with local inflammation of the ciliary body associated with the varicella-zoster virus

Kovaleva L.A., Krichevskaya G.I., Davydova G.A., Zaitseva A.A.


AIM: To analyze the etiopathogenesis, clinical features, and treatment algorithm for chronic unilateral anterior nodular scleritis with local inflammation of the ciliary body to increase medical alertness to the herpetic etiology of the disease in the absence of extraocular manifestations of herpes infection, reduce the disease duration, and increase the effectiveness of treatment.

RESULTS: Features of etiopathogenesis were analyzed. The characteristic clinical symptoms of chronic nodular scleritis, local anterior cyclitis, and pars planitis caused by the varicella-zoster virus (VZV) were described. The etiological role of VZV has been established based on high levels of VZV-IgG antibodies, presence of VZV-gE-IgG antibodies (markers of active virus replication), and effectiveness of antiherpetic therapy.

DISCUSSION: The surgical removal of a melanocytic skin nevus with skin autotransplantation in the paraorbital region of the left eye, in the zone of innervation of the first branch of the trigeminal nerve, contributed to the reactivation of the ophthalmic herpes and the development of anterior nodular scleritis of the left eye. An intensive long-term ineffective therapy with corticosteroids and antibacterial drugs in the absence of etiotropic treatment caused a chronic course of anterior nodular scleritis, spread of the inflammatory process to the ciliary body, and development of local anterior cyclitis and pars planitis of herpetic etiology in a 17-year-old child.

CONCLUSION: Maximum medical alertness and early and accurate clinical differential diagnosis between scleritis associated with immunoinflammatory rheumatic diseases and herpesvirus infections are necessary since the expansion of the range and number of anti-inflammatory drugs used in the absence of positive dynamics from their use leads to a chronic disease course, damage not only to deep layers of the sclera but also the spread of inflammation to the deeper layers of the eyeball, a decrease in visual acuity, undesirable effects of local glucocorticoid therapy, and an increase in intraocular pressure and development of cataracts. With any scleritis resistant to conventional treatment, the likelihood of a herpetic etiology of the inflammatory process and laboratory diagnosis of ophthalmic herpes should be considered. In the absence of a specialized laboratory, for etiological diagnosis, the possibility of ex juvantibus antiviral therapy should be considered. The described clinical symptoms of chronic nodular scleritis with local lesions of the ciliary body contribute to the early diagnosis of ophthalmoherpes, which allows the timely initiation of antiviral therapy with an antiherpetic effect, prevents the development of a chronic disease course, occurrence of complications, and preservation and/or restoration of visual acuity.

Russian Pediatric Ophthalmology. 2022;17(2):31-38
pages 31-38 views

Сase of congenital cataract development in a child with Farh disease

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


INTRODUCTION: Fahr disease is a rare idiopathic neurodegenerative disorder characterized by the calcification of the basal ganglia, cerebellar dentate nuclei, and surrounding white matter leading to progressive nervous system dysfunction. Cases of congenital cataracts are not described.

AIM: To describe a clinical case of congenital cataract in a pediatric patient with Farh disease.

MATERIAL AND METHODS: Congenital atypical progressive metabolic cataract was diagnosed in a 9-year-old child. Congenital cataract extraction with intraocular lens implantation was performed.

RESULTS: Refraction before operation was sph+2.0 cyl+1.5 ax 107 and sph+0.25 cyl+1.25 ax 74, respectively. The preoperative visual acuity for both eyes was 0.5 log MAR and 1.0 log MAR, respectively. Crystalline lenses were cloudy with atypical star-shaped infusions. Full-field electroretinogram (ERG) a-wave and b-wave were normal for OD and abnormal for OS, and flicker ERG was normal for both eyes. Visually evoked potentials were prolonged for both eyes. The intraocular pressure was normal for both eyes. The axial lengths were 22.60 mm and 22.62 mm, respectively. Exudative reaction was noted postoperatively, and the logMar visual acuity improved to 0.2 for both eyes.

CONCLUSION: Congenital cataracts may be diagnosed in patients with Fahr disease. Dynamic examination of the child with a wide pupil is necessary to identify initial changes in the lens and to refer him/her for surgical treatment. There is an increased risk of exudative reactions in the early postoperative period.

Russian Pediatric Ophthalmology. 2022;17(2):39-44
pages 39-44 views

Long-term treatment as chorioretinitis of atypical optic disk pit complicated by retinal detachment in the macular zone

Katargina L.A., Denisova E.V., Osipova N.A.


Changes in the macular zone of the retina, which have different etiopathogenesis, can occur with a similar ophthalmoscopic picture.

AIM: To present the clinical case of a child with a congenital the optic disc pit, complicated by retinal detachment in the macular zone, who received long-term treatment for chorioretinitis.

RESULTS: A 13-year-old child was referred to the Helmholtz National Medical Research Center for a diagnosis of an idiopatic chorioretinal inflammation in the right eye. For 2 years at home, the child received inpatient treatment, including anti-inflammatory, desensitizing, and antibacterial therapy, without changes in visual acuity, ophthalmoscopy, and optical coherence tomography (OCT) data. Based on a comprehensive assessment of OCT results of the macular area and the optic nerve head (presence of a peripapillary slit-like detachment of the neuroepithelium in the superior temporal and inferior temporal quadrants, detachment of the neuroepithelium in the macula), anamnesis (lack of a “response” to ongoing anti-inflammatory therapy), biomicroscopy, and ophthalmoscopy (on the right, the optic disc is oval, horizontally elongated, decolorized, along the horizontal meridian it is made of glial tissue, in the area of the papillomacular bundle and in the macula, there is a rough redistribution of pigment. On the left, the optic disc is oval, horizontally elongated, decolorized, the macula and the periphery without pathology), the diagnosis was made: a congenital anomaly in the development of the optic disc (optic disc pit) in both eyes complicated by retinal detachment in the macula on the right. The child underwent transpupillary laser coagulation of the retina in the parapapillar zone in the upper and lower temporal quadrants of the right eye. Upon further observation after 1 and 2 months, OCT data revealed positive dynamics of resorption of the subretinal fluid in the macular zone, and an increase in visual functions was noted.

CONCLUSION: Сompetent interpretation and integration of the results of clinical and instrumental examinations and thorough analysis of anamnestic data make it possible to identify the pathology underlying structural disorders of the macular zone, which is of key importance in choosing the right treatment techniques and maintaining visual functions.

Russian Pediatric Ophthalmology. 2022;17(2):45-52
pages 45-52 views

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