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Characteristic of uveitis of children had treated in hospital 在医院接受治疗的儿童葡萄膜炎的特点
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-98-100
T. V. Kukuyuk, E. Gromakina
Systematization of data on uveitis in childhood is an important step in assessing the quality of treatment, the prevalence of the disease, etiology and the complications. Due to statistical data processing, the incidence of complications was revealed, which were considered as independent diseases not associated with the previous manifestation of uveitis. Key words: uveitis, iridocyclitis, childhood, complications
儿童葡萄膜炎数据的系统化是评估治疗质量、发病率、病因和并发症的重要一步。由于对数据进行了统计处理,揭示了并发症的发生率,这些并发症被认为是与葡萄膜炎之前的表现无关的独立疾病。关键词:葡萄膜炎、虹膜睫状体炎、儿童、并发症
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引用次数: 0
Study of the effectiveness of the treatment of endothelial vascular dysfunction in various stages of primary open-angle glaucoma 原发性开角型青光眼各期内皮血管功能障碍治疗效果研究
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-71-78
A. M. Dusmukhamedova, D. Tuychibaeva
Relevance. According to literary sources, POAG is considered as a chain of interaction of etiological and pathogenetic factors, among which the leading role is played by genetic predisposition, general changes, ischemia, primary local functional and dystrophic changes, disturbances in hydrostatics and hydrodynamics of the eye, increased intraocular pressure, vascular disorders, dystrophy and tissue degeneration. Purpose of the study. To assess the severity of endothelial dysfunction in patients with different stages of primary open-angle glaucoma during complex therapy. Material and research methods. The study included 92 patients with POAG aged 65 to 80 years, who were divided into three groups. We studied the levels of endothelin-1, VEGF and von Willebrand factor before and after the recommended treatment in patients with POAG. Conclusion. The developed complex therapy of various stages in patients with POAG contributed to the correction of the identified disorders in relation to markers of endothelial dysfunction. The features of changes in ED markers in patients with POAG have been established; low levels of von Willebrand factor, VEGF and endothelin-1, which indicates the role of pathogenetic factors in the formation of endothelial dysfunction and the importance of studying markers of endothelial dysfunction. Keywords: primary open-angle glaucoma, endothelial markers, von Willebrand factor, VEGF, endothelin-1, complex therapy
相关性。根据文献资料,POAG 被认为是病因和致病因素相互作用的一个链条,其中起主导作用的是遗传易感性、全身变化、缺血、原发性局部功能和萎缩性变化、眼球流体静力学和流体动力学紊乱、眼压升高、血管紊乱、萎缩和组织变性。研究目的评估不同阶段的原发性开角型青光眼患者在复合治疗期间内皮功能障碍的严重程度。材料和研究方法。研究纳入了 92 名年龄在 65 至 80 岁之间的原发性开角型青光眼患者,将其分为三组。我们研究了 POAG 患者在接受推荐治疗前后的内皮素-1、血管内皮生长因子和 von Willebrand 因子水平。最后得出结论。针对 POAG 患者制定的不同阶段的复合疗法有助于纠正已发现的与内皮功能障碍标志物有关的紊乱。POAG患者ED标志物变化的特征已经确定;低水平的von Willebrand因子、血管内皮生长因子和内皮素-1,这表明了致病因素在内皮功能障碍形成中的作用,以及研究内皮功能障碍标志物的重要性。关键词:原发性开角型青光眼;内皮标志物;冯-威廉因子;血管内皮生长因子;内皮素-1;复合疗法
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引用次数: 0
Clinical and functional results of complex treatment of dry eye disease on the background of intermediate uveitis 中度葡萄膜炎背景下干眼症复合治疗的临床和功能效果
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-121-127
E. Tatarnikova, O. I. Krivosheina
Relevance. Inflammation and impaired stability of the pre-corneal tear film are central to the pathogenesis of dry eye disease (DED). Signs of ocular surface irritation and symptoms characteristic of DED accompany intermediate uveitis in 28–57 % of cases. Purpose. To evaluate clinical and functional results of treatment of DED and intermediate uveitis, including tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus. Materials and methods. The results of treatment of 78 patients with DED and intermediate uveitis were analyzed. The effectiveness of the developed method of treatment of combined pathology was evaluated after 3, 6, 12, 18 months based on the dynamics of OSDI index, hyperemia of bulbar conjunctiva, LIPCOF test, Schirmer I test and Norn's test. Results. Application of complex treatment of DED in patients with intermediate uveitis promotes statistically significant (p≤ 0.05) decrease of discomfort signs according to OSDI results up to 34.7 %, decrease of bulbar conjunctiva hyperemia index up to 50 %, decrease of LIPCOF test index up to 27.2 %, increase of tear film rupture time up to 31.6 % and total tear production up to 89.7 % with stable cure of intermediate uveitis during 18 months of observation. Conclusions. Tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus is an effective method of treatment of DED and intermediate uveitis, providing stable clinical and functional results for a long time. Keywords: dry eye disease, intermediate uveitis, laser coagulation of the extreme periphery of the retina
相关性。炎症和角膜前泪膜稳定性受损是干眼症(DED)发病机制的核心。在 28%-57% 的病例中,中度葡萄膜炎会伴有眼表刺激症状和 DED 的特征性症状。目的评估 DED 和中间葡萄膜炎治疗的临床和功能效果,包括泪液置换和抗炎治疗,以及眼底极周边激光视网膜凝固术。材料和方法。对 78 名 DED 和中间葡萄膜炎患者的治疗结果进行了分析。根据 OSDI 指数、球结膜充血、LIPCOF 试验、Schirmer I 试验和 Norn 试验的动态变化,在 3、6、12、18 个月后评估了所开发的综合病理学治疗方法的有效性。结果在18个月的观察期间,对中度葡萄膜炎患者应用DED复合疗法可使OSDI结果显示的不适症状显著减少34.7%(P≤0.05),球结膜充血指数显著减少50%,LIPCOF测试指数显著减少27.2%,泪膜破裂时间显著增加31.6%,泪液总分泌量显著增加89.7%,中度葡萄膜炎得到稳定治愈。结论是泪液置换和抗炎疗法结合眼底极周边激光视网膜凝固术是治疗 DED 和中间葡萄膜炎的有效方法,可长期提供稳定的临床和功能效果。关键词:干眼症、中间葡萄膜炎、视网膜极周边激光凝固术
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引用次数: 0
Features of drug therapy in the pre- and postoperative period in patients with glaucoma who underwent vitreoretinal intervention 接受玻璃体视网膜介入治疗的青光眼患者术前和术后的药物治疗特点
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-101-106
P. A. Perevozchikov, D. Peregudov, D.N. Lovpache, D.A. Merkushenkova
Cystoid macular edema (CME, Irwine-Gass Syndrome), despite modern methods of postoperative rehabilitation, remains an urgent problem in ophthalmology. It is most common in cataract surgery, but it also occurs with successfully performed vitreoretinal surgery. Purpose. Analysis of the causes of the development of CME and optimization of the tactics of treatment of patients with glaucoma who underwent vitreoretinal intervention. Material and methods. 6 people with CME after vitreoretinal surgery aged 69.2 ± 7.1 years were under observation at the Tri-Z clinic branch in Moscow in 2022. Vitrectomy was performed in 4 patients (66.7 %) for vitreomacular interface pathology, in two patients (33.3 %) for retinal detachment. All patients received locally prostaglandin analogues (PА) for primary open-angle glaucoma. Tactics of management of patients with glaucoma in CME: 1) cancellation of PA and replacement with therapy of similar efficacy (a combination of drugs from other groups in the absence of contraindications to their use); 2) in CME with retinal thickness up to 450 microns, Diprospan ® injection was performed parabulbar and bromfenac 0.09 % was administered locally twice a day for 2 months.; 3) with CME with a retinal thickness of more than 450 microns, dexamethasone 0.7 mg (Ozurdex®) implant was injected into the vitreal cavity and bromfenac 0.09 % was administered locally twice a day for 2 months. Results. In all patients, retinal thickness decreased from 516.2 ± 125.1 microns to 334.6 ± 62.6 microns (p< 0.05, U-criterion). After 1 month after treatment, the MVA improved from 0.41 ± 0.09 to 0.88 ± 0.11 (p< 0.05, t-criterion). Conclusions. The use of PA in patients with glaucoma may provoke CME, which requires their replacement with a combination of drugs without loss of antihypertensive efficacy. The appointment of bromfenac 0.09 % for prolonged use (up to 2 months or more) after vitreoretinal surgery reduces the risk of developing CME. The proposed tactics of management of patients with glaucoma in CME has shown its effectiveness. Keywords: cystoid macular edema, Irwine-Gass Syndrome, vitreoretinal surgery, prostaglandin analogues
尽管采用了现代化的术后康复方法,囊样黄斑水肿(CME,Irwine-Gass 综合征)仍然是眼科领域亟待解决的问题。它在白内障手术中最为常见,但在成功实施玻璃体视网膜手术后也会发生。目的分析发生 CME 的原因,优化对接受玻璃体视网膜手术的青光眼患者的治疗策略。材料和方法。2022年,莫斯科Tri-Z诊所分部观察了6名玻璃体视网膜手术后出现CME的患者,年龄为(69.2±7.1)岁。4名患者(66.7%)因玻璃体黄斑界面病变而进行了玻璃体切除术,2名患者(33.3%)因视网膜脱离而进行了玻璃体切除术。所有患者都在当地接受了前列腺素类似物(PА)治疗原发性开角型青光眼。治疗青光眼合并视网膜脱离患者的方法有:1)取消前列腺素类似物治疗,改用疗效相似的药物(在没有使用禁忌症的情况下,联合使用其他组别的药物);2)视网膜厚度达 450 微米的合并视网膜脱离患者,在眼底注射 Diprospan ®,在局部注射溴芬酸 0.09 %,每天两次,持续 2 个月;3)视网膜厚度超过 450 微米的 CME,在玻璃体腔内注射地塞米松 0.7 毫克(Ozurdex®)植入物,并在局部注射溴芬酸 0.09 %,每天两次,持续 2 个月。结果所有患者的视网膜厚度从 516.2 ± 125.1 微米降至 334.6 ± 62.6 微米(p< 0.05,U 标准)。治疗 1 个月后,MVA 从 0.41 ± 0.09 提高到 0.88 ± 0.11(p< 0.05,t 标准)。结论青光眼患者使用 PA 可能会诱发 CME,这就需要在不降低降压疗效的前提下使用联合药物来替代 PA。在玻璃体视网膜手术后长期(长达2个月或以上)使用0.09%溴芬酸可降低发生CME的风险。对青光眼患者进行CME管理的建议策略已显示出其有效性。关键词:囊样黄斑水肿、Irwine-Gass 综合征、玻璃体视网膜手术、前列腺素类似物
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引用次数: 0
A clinical case of complex treatment for paralytic lagophthalmos complicated by neurotrophic keratopathy 神经营养性角膜病并发麻痹性眼睑下垂的复杂治疗临床病例
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-52-59
M. Gushchina, A. V. Tereshchenko, D. Afanasyeva, E. Erokhina, S. K. Demyanchenko
Introduction. Combined leisure of facial and trigeminal nerves causes paralytic lagophthalmos and severe neurotrophic keratopathy that can lead to significant loss of vision. Material and methods. This article describes a clinical case of step-by-step complex surgical treatment in paralytic lagophthalmos accompanied by neuropathic keratopathy complicated by fistula of corneal graft. Results. The performed three stepped surgeries to improve lagophthalmos and corneal nerve supply resulted in subcompensation of lagophthalmos and restoration of corneal sensitivity up to the low limit. This was accompanied by heeling of long lasting corneal fistula. Conclusion. Pathogenetic treatment of combined paralytic changes, that includes correction of eyelid position and direct corneal neurotization, provides medical and social rehabilitation of patients with paralytic lagophthalmos complicated by neurotrophic keratopathy. Keywords: facial nerve, trigeminal nerve, neuropathic keratopathy, corneal neurotization, corneal fistula
导言。面神经和三叉神经的合并闲置会导致麻痹性眼睑下垂和严重的神经营养性角膜病,从而导致视力严重下降。材料和方法。本文描述了一例麻痹性眼睑下垂伴神经性角膜病并发角膜移植瘘管的分步复杂手术治疗的临床病例。结果。为改善眼睑下垂和角膜神经供应而进行的三次分步手术使眼睑下垂得到亚补偿,角膜敏感度恢复到低限。与此同时,长期存在的角膜瘘也被治愈。结论对合并麻痹性病变的病因治疗,包括眼睑位置矫正和直接角膜神经化,可为并发神经营养性角膜病的麻痹性眼睑下垂患者提供医疗和社会康复。关键词:面神经、三叉神经、神经营养性角膜病、角膜神经化、角膜瘘
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引用次数: 0
Alcohol is undisputed evil, but the patient is lucky 酒精是无可争议的恶魔,但患者是幸运的
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-79-85
A.A. Ermolova, Y.A. Plotnikova, L.V. Belyh
Periorbital necrotizing fasciitis is a rare soft tissue infection that occurs mainly as a result of trauma in susceptible patients with immunocompromised or chronic diseases. We present a clinical case of preseptal periorbital necrotizing fasciitis that occurred in a patient after an injury. The clinic, diagnostic tactics, stages of surgical treatment, conservative treatment with a step-by-step photo demonstration are described in detail. As a result of the applied treatment, the patient achieved a satisfactory anatomical and functional state of the eyelids, visual functions were preserved. Keywords: necrotizing fasciitis, periorbital region
眶周坏死性筋膜炎是一种罕见的软组织感染,主要发生在免疫力低下或患有慢性疾病的易感患者身上。我们介绍了一例眶周坏死性筋膜炎的临床病例,该病例发生在一名受伤后的患者身上。病例详细描述了临床、诊断策略、手术治疗阶段、保守治疗,并配有逐步的图片演示。经过治疗,患者眼睑的解剖和功能状态令人满意,视觉功能得以保留。关键词:坏死性筋膜炎、眶周
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引用次数: 0
Assessment of ocular surface morbidity among personnel of a nuclear energy facility 核能设施工作人员眼表发病率评估
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-128-133
L.R. Takhauova, O. I. Krivosheina
Relevance. One of the main areas of scientific support for work in the field of ensuring radiation safety during the liquidation of nuclear legacy is the assessment of radiation effects among personnel of nuclear industry enterprises and the most significant radiogenic risks among workers of these enterprises. Objective. To conduct a retrospective analysis of ocular surface morbidity among personnel of a nuclear energy facility under long-term man-made external irradiation. Materials and methods. A retrospective analysis of ocular surface morbidity among personnel of a nuclear energy facility (NUF) under long-term man-made external irradiation was carried out, taking into account the absorbed dose equivalent. The medical records of 3,795 employees were analyzed, divided into 2 groups: main - medical records of 2,546 employees of the main production; comparison - medical records of 1249 employees of auxiliary production. Results. According to the results of a retrospective analysis, blepharoconjunctivitis, inflammation of the lacrimal drainage apparatus, and inflammatory lesions of the cornea are the most common among OAE personnel. At the same time, there is a statistically significant increase in the pathology of the ocular surface as the dose load increases among personnel of both the main and auxiliary production facilities of nuclear power plants. Conclusion. Among nuclear facility personnel exposed to long-term technogenic exposure to ionizing radiation, there is a statistically significant increase in the number of cases of ocular surface diseases as the dose load of soft tissues increases. Keywords: ionizing radiation, long-term technogenic external exposure, ocular surface, morbidity
相关性。为确保核遗产清理期间辐射安全领域的工作提供科学支持的主要领域之一,是评估核工业企业人员的辐射影响以及这些企业工人的最大辐射风险。目标。对核能设施工作人员在长期人为外照射下的眼表发病率进行回顾性分析。材料和方法。考虑到吸收剂量当量,对核能设施(NUF)工作人员在长期人工外照射下的眼表发病率进行了回顾性分析。分析了 3,795 名员工的医疗记录,分为两组:主要--主要生产部门 2,546 名员工的医疗记录;对比--辅助生产部门 1249 名员工的医疗记录。结果。根据回顾性分析的结果,眼睑结膜炎、泪腺引流器炎症和角膜炎症性病变在 OAE 人员中最为常见。同时,随着剂量负荷的增加,核电站主生产设施和辅助生产设施人员的眼表病变在统计学上有显著增加。结论在长期受到电离辐射技术照射的核设施人员中,随着软组织剂量负荷的增加,眼表疾病的病例数在统计学上有显著增加。关键词:电离辐射、长期技术性外部照射、眼表、发病率
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引用次数: 0
Manifestations of dry eye syndrome in children with type 1 diabetes depending on the level of glycated hemoglobin 1 型糖尿病患儿干眼症的表现取决于糖化血红蛋白的水平
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-7-20
V. R. Abdullina
Introduction. Diabetes mellitus is one of the serious diseases that leads not only to restrictions on physical activity, but also changes the social and psychological spheres of life of patients. The purpose of the studyis to evaluate the results of functional methods for studying tear production function in children with type 1 diabetes mellitus. Materials and methods of research. The study included 240 children registered at the Children's City Endocrinology Center in Almaty. There were 133 boys (55.42 %), 107 girls (44.58 %). The examined children were divided into 6 groups depending on the level of glycated hemoglobin (HbA1c). The control group consisted of 52 people. All patients were assessed for the severity of blockage of the breast ducts, the state of total tear production (Schirmer test 1), the state of the tear meniscus (biometry of the tear meniscus), the time of tear film rupture, and the state of the conjunctiva. Patients with dry eye syndrome were prescribed softdrops and the dynamics of the process were monitored. Research results. In patients with type 1 diabetes mellitus, in 69.6 % of cases there were manifestations of breast dysfunction of varying severity. From 17 % to 39.8 % of patients in the main groups had manifestations of hyperemia and 28 % mild conjunctival edema, which is clinically a sign of the presence of an irritating factor, possibly due to an increase in tear hyperosmolarity. The Schirmer test showed a decrease in tear secretion function, a decrease in tear film rupture and a decrease in the level of menisci in comparison with the control. The use of softdrops eye drops helps to stabilize the tear film, increase tear secretion and tear production functions in children with signs of dry eye syndrome due to type 1 diabetes mellitus. These studies should be taken into account when prescribing pathogenetic therapy for the correction of dry eye syndrome in these groups of patients. Keywords: diabetes mellitus, ophthalmological manifestations of diabetes mellitus, dry eye syndrome, dry eye disease
引言糖尿病是一种严重的疾病,它不仅会限制患者的身体活动,还会改变患者的社会和心理生活。本研究的目的是评估研究 1 型糖尿病儿童泪液分泌功能的功能方法的结果。研究材料和方法。研究对象包括在阿拉木图市儿童内分泌中心登记的 240 名儿童。其中男孩 133 名(55.42%),女孩 107 名(44.58%)。根据糖化血红蛋白(HbA1c)的水平,受检儿童被分为 6 组。对照组有 52 人。所有患者都接受了乳腺导管堵塞严重程度、总泪液分泌状况(Schirmer 测试 1)、泪液半月板状况(泪液半月板生物测量)、泪膜破裂时间和结膜状况的评估。为干眼症患者开具软眼药水,并对这一过程的动态进行监测。研究结果在 1 型糖尿病患者中,69.6% 的病例有不同程度的乳房功能障碍表现。在主要组别中,17%至 39.8%的患者有充血表现,28%的患者有轻度结膜水肿,这在临床上是刺激因素存在的一种迹象,可能是由于泪液高渗增加所致。施尔默试验显示,与对照组相比,泪液分泌功能下降,泪膜破裂率下降,半月板水平下降。使用软滴眼液有助于稳定泪膜,增加因 1 型糖尿病而出现干眼症症状的儿童的泪液分泌和泪液生成功能。在为这些患者群体开具治疗干眼症的病理疗法处方时,应考虑到这些研究结果。关键词:糖尿病;糖尿病的眼科表现;干眼综合征;干眼病
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引用次数: 0
A clinical case of transudative retinal detachment in ethmoiditis 乙状腺炎引起的视网膜渗出性脱离临床病例
Pub Date : 2023-10-29 DOI: 10.25276/2312-4911-2022-6-134-140
Y. Khzardzhan, I. A. Melikhova, M.V. Sokolova, M.A. Korotkov, A. S. Balalin
A clinical case of diagnosis and treatment of transudative retinal detachment in ethmoiditis was analyzed. Application of modern diagnostic methods allowed to determine transudative retinal detachment. MRI of the sinuses made it possible to find evidence for ethmoiditis. Confirmation of the diagnosis and treatment by an ENT doctor led to the patient's recovery. Keywords: transudative retinal detachment, ethmoiditis
本文分析了一个诊断和治疗乙状结肠炎视网膜渗出性脱离的临床病例。应用现代诊断方法确定了经渗性视网膜脱离。鼻窦核磁共振成像发现了乙状腺炎的证据。经耳鼻喉科医生确诊和治疗后,患者康复出院。关键词:渗出性视网膜脱离、乙膜炎
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引用次数: 0
Restoration of the ellipsoid zone of the retina in various pathological processes 各种病理过程中视网膜椭球带的恢复
Pub Date : 2023-05-29 DOI: 10.25276/2312-4911-2023-2-103-108
E. Kozlova, M.S. Kholmogorov, V.N. Badanova, T. Iureva, D. Bronsky
Purpose. To present the possibility of the ellipsoid zone restoration and the retina in various types of macular pathology and to determine the relationship with changes in visual acuity using the example of a number of clinical cases. Material and methods. All the patients underwent standard examination, including visometry, ophthalmoscopy, optical coherence tomography (OCT) (Оptovue, USA). Results. The results of the presented clinical cases demonstrate, on the one hand, the possibility of the ellipsoid zone restoration of the macula and the corresponding improvement in visual functions in patients after inflammatory pathological processes and macular holrs of stage III according to classification J. Gass, under the condition of the preservation of the inner retinal layers and the short duration of the pathological process. In contrast, the structural restoration of the ellipsoid zone with large macular holes does not allow to obtain a significant functional result. Keywords: ellipsoid zone, macular hole, chorioretinitis
目的。目的探讨椭圆区恢复和视网膜在不同类型黄斑病变中的可能性,并结合一些临床病例分析其与视力变化的关系。材料和方法。所有患者均接受了标准检查,包括粘度测定、眼科检查、光学相干断层扫描(OCT) (Оptovue,美国)。结果。本临床病例的结果表明,一方面,在保留视网膜内层和病理过程持续时间短的情况下,炎症病理过程和J. Gass分类的III期黄斑时间后,黄斑椭球区恢复和视觉功能改善的可能性。而对黄斑大孔椭球区进行结构修复则不能获得明显的功能效果。关键词:椭球带,黄斑孔,脉络膜视网膜炎
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引用次数: 0
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Modern technologies in ophtalmology
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