REVIEWS
Practitioners in ophthalmology in recent years often face the effects of cosmetic procedures on the paraorbital area, as well as directly on the eyelids. Such influences include botox injections in paraorbital area, blepharoplasty, eyelash extensions, injections of various fillers, etc. These manipulations are widely used and often lead to various complications of the vision organ. Eyelash extensions are a popular procedure, especially among urban, young women, but there are potential health risks from the procedure. Tattooing of eyelids leads is the cause of dysfunction of meibomian glands, which can lead to the dry eye syndrome, manifested as complaints about a feeling of chronic discomfort in the eyes. Due to the growing popularity of the age tattoo, it is necessary to pay close attention to the training of specialists who conduct this procedure. The procedure for permanent eyelid make-up should be performed after careful consideration of possible complications, and by special trained professionals. In recent years, various cosmetic procedures for rejuvenating the face plays great role, for example, injections of botulinum toxin, as well as various dermal fillers — the application of which is aimed at eliminating the aging signs. The qualification of the specialist his awareness of the occurrence of possible complications, as well as the awareness of patients who undergo this procedure is an important aspect in the application of botulinum toxin, both for therapeutic and cosmetic purposes. Of great interest are the complications associated with ischemia in the form of soft tissue necrosis and vascular occlusion caused by fillers introduction. It is reported that the frequency of vascular occlusion with dermal fillers is up to 3 per 1000 injections. The only proven elimination of soft tissue ischemia in case of a hyaluronic acid filler use is early high-dose hyaluronidase injections, since this drug helps deactivate the action of hyaluronic acid. Modern ophthalmologic practice is inextricably linked with the latest methods of modern cosmetology medicine, the results of it can effect on the functions of the whole organism as the organ of vision in particular. This fact and the specificity of possible complications arising from cosmetic procedures in the periorbital zone should be taken into account during the anamnesis collecting anamnesis, and examining patients, including preoperative preparation, and in choosing the treatment method.
OPHTHALMOSURGERY
According to WHO, corneal pathology is the fourth cause (5.1 %) of blindness among the main causes of significant visual impairment in the world after cataract, glaucoma and macular degeneration. Bullous keratopathy is a serious progressive corneal disease, in which the endothelial lesion plays the main role leading to the chronic corneal edema, reduce of visual acuity, development of pain syndrome, formation of permanent opacities, and various infectious complication, which may result in eye globe loss. Since the second half of 90th XX century various modifications of modern posterior (endothelial) keratoplasty have been introduced in the clinical practice, which were subsequently used widely for the treatment of bullous keratopathy. The introduction of new microkeratomes used in refractive surgery significantly contributed to the development of endothelial keratoplasty microsurgical technique, which enables the high quality, selective replacement of the affected corneal layers in comparison to the manual lamellar keratoplasty techniques. One of the contraindications for endothelial keratoplasty is an irreversible central stromal opacity. In that case, modern technologies and new equipment (particularly femtosecond laser) provide an opportunity to perform the penetrating keratoplasty with a complex-shaped profile and corresponding edges of the graft and its bed. In bullous keratopathy, top-hat keratoplasty represents the pathogenically targeted treatment method that allows transplanting of more endothelial cells with a relatively smaller diameter of graft’s anterior segment. This article reviews the literature on modern surgical treatment of bullous keratopathy.
Purpose: to evaluate the clinical results of trifocal intraocular lenses implantation with different optical characteristics; optimization of preparation stages and intraocular correction of presbyopia. Patients and Methods. Phacoemulsification with binocular implantation of trifocal intraocular lenses (IOL) was performed in 35 patients with cataract and presbyopia. IOL AcrySof® IQ PanOptix® was implanted in 32 eyes, AT LISAtri839MP — 38 eyes. Preoperative evaluation included standard examination with surgeon’s consultation and clarification of patients’ lifestyle and vision motivations at all distances. Postoperative evaluation included measurement of refraction, visual acuity at three distances, quality and visual acuity under mesopic conditions. Proposed to use the test questionnaire, visual acuity testing tables at intermediate distances, nomograms for IOLs power calculation developed by the authors. Results. Postoperative spherical refraction was 0.17 ± 0.23D, which did not exceed 0.5D deviation from the target refraction. Uncorrected distance visual acuity ≤ 0.5 reached in 100 % of patients on the first day after surgery. Visual acuity ≤ 0.5 at intermediate distance was achieved in 34 eyes (89.5 %) of patients with implanted IOL AT LISAtri, and the same results has been recorded for near in 33 eyes (86.8 %). On the next day after surgery in the PanOptix® group, all patients monocular gave ≤ 0.6 for intermediate and near, and 96.9 % of eyes ≤ 0.5 for far. All patients from both groups (PanOptix® or LISAtri) after 6 months binocular showed visual acuity ≤ 0.8 for far, near or intermediate distances, no patient noted a need to use any spectacle correction and did not notice significant visual impairment in mesopic conditions. Conclusion. Implantation of Trifocal IOLs AcrySof® IQ PanOptix® and AT LISAtri 839MP allows patients spectacle independence and high-quality of vision in mesopic conditions. An individual approach to each patient, concomitant ophthalmopathology, general status, life style, primary refraction and precise IOLs power calculation, allows the surgeon widely to apply this technology for presbyopia intraocular correction.
Ulcerative lesions of the cornea in 17–21 % lead to functional and up to 8 % to anatomical death of the eye depending on the severity. The aim of the work was to develop an algorithm of surgical treatment of patients with corneal ulcers. Comprehensive examination, treatment and outcomes in the dynamics of ulcerative lesions was performed in 126 patients, 86 patients of them received surgical intervention (with the threat of corneal perforation or present) for emergency indications and in 40 cases combined treatment was carried out with the use of a crosslinking (CRL) in corneal ulcer and ulcer a corneal transplant. Surgical intervention included autoconjuctival plasty (AUC), the transplantation of amniotic membrane in combination with blepharorrhaphy (TAM + BR), lamellar keratoplasty (PKP), penetrating keratoplasty (PK), reconstructive keratoplasty (RCP). The most favorable outcomes with relief of inflammation were achieved in RCP and PC. In cases of delayed epithelialization of the cornea and graft (herpesvirus infection and trophic disorders), the most resonant ones were TAM and TAM + BR. CRL treatment was carried out in 3 variants: 1-as the main method of treatment, 2 — CRL in combination with TAM + BR, 3 — CRL + keratoplasty ( 5–7 days after surgery). As a treatment result, epithelialization of ulcerative-destructive process and partial increase in visual acuity were observed in all patients. Based on the results of patient’s treatment the algorithm of complex surgical care was created. It takes into account the etiology, localization, depth and severity of the inflammatory process, the area of ulcerative lesions of the cornea and of the graft, reduced terms of treatment inflammation and rehabilitation period.
Purpose: to compare in vivo histomorphologic structure of cornea after the FemtoLASIK procedure using femtolaser systems Femto Visum (Russia) and Femto LDV Z6 (Switzerland). Patients and methods: The study was carried for 70 eyes from 70 patients with low to moderate myopia after FemtoLASIK procedure. Group 1 (Femto Visum) included 36 eyes (n = 36) there the flap were formed using femtolaser Femto Visum («Optosystems», Russia), group 2 (Femto LDV Z6) included 34 eyes (n = 34) and Femto LDV Z6 was used («Ziemer Ophthalmic Systems AG», Switzerland). The excimer laser ablation was performed with Microscan Visum system («Optosystems», Russia) in both groups. The Femto Visum and Femto LDV Z6 groups were comparable in terms of pre-operative data (age, sex, corneal curvature, central corneal thickness, sphere, cylinder, spherical equivalent) (p > 0.05). In vivo histomorphological structure of the cornea was examined using confocal microscope Confoscan 4 (Nidek, Japan) 1 week, 1, 3, 6, and 12 months after FemtoLASIK. The endothelial cell density (ECD) was measured with endothelial microscope (EM-3000, Tomey, Japan) before surgery and 12 months after FemtoLASIK. Results: The main in vivo histomorphological cornea changes occurred in the anterior and middle layers of the corneal stroma during post-operative period in both groups (Femto Visum and Femto LDV Z6). The underlying corneal structures remained intact. There was no statistically significant difference between the two groups (p > 0.05). Twelve months postoperatively, the loss of ECD was 0.31 % in the Femto Visum group and 0.33 % in the Femto LDV Z6 group (p > 0,05). Conclusions: FemtoLASIK procedures using Femto Visum (Russia) and Femto LDV Z6 (Switzerland) lead to similar histomorphological cornea changes in post-operative period (p > 0.05) and they are safe for corneal structure in the treatment of myopia.
Objective: Comparative analysis of the results of phacoemulsification (FEC) with the use of developed and classic technologies for fragmentation of the lens nucleus in patients with pseudoexfoliation syndrome (PES). Patients and methods. The proposed technology is gentle crushing of the lens nucleus in patients with PES, you can reduce the pressure on the fibers of the zonule, the probability of damage to the ligaments and posterior capsule of the lens based on the use of phacofragmentation original design. To determine the radius of curvature of the working part of the tool a morphometrical measurement of the curvature of the equatorial zone of the lens cores removed during extracapsular and intracapsular cataract extraction in patients with PEX subluxation of the lens was carried out. A comparative analysis of the operation and the results of surgical treatment of cataract in patients with PEX with the use of the proposed (n = 58) and standard (n = 56) technologies of the nucleus fragmentation in phacoemulsification was made. The following ultrasound parameters were estimated: the average capacity in % (AVEUS), the average values of the absolute time ultrasound (APT) and average values of effective (EPT) time of ultrasound, in seconds, during phacoemulsification; structural-morphological changes in the posterior epithelium of the cornea according to the endothelial microscopy; the frequency and nature of complications, the visual acuity. Results. Morphometry of the lens nuclei in patients with pseudoexfoliation syndrome allowed to determine the average radius of curvature of the nucleus equator, which is made up 2.89 ± 0.14 mm, according to the performance curve of the Gauss — 2.895– 3.530 mm. These data are taken into account when selecting the radius of curvature of the working part of phacofragmentation (the radius of curvature of 3.0 mm) used with FEC in patients with PES (Patent RU152761 from 25.05.2015). The proposed chopper due to the conformity of the working part curvature of the tool and the Equatorial zone of cataract kernel can reliably capture and grind it, thus eliminating excessive pressure on the ligaments of the crystalline lens in patients with PES. Developed technology contributes to significantly reduction of the energy performance of ultrasound: AVEUS — 2.64–10.00 %; APT — 3.38–14.00 %; EPT — on 3.76– 16.00 % by 6.76 % in patients with different of the lens nucleus density degree, decrease operative and postoperative complications twice, 1.5 times less cell loss back the corneal epithelium. Visual acuity without correction from the first days after surgery was higher than 0.5 (average of 0.70 ± 0.05) in all the patients and increased to an average of 0.91 ± 0.01 within 12 months in patients of the main and 0.85 ± 0.02 — control groups. Conclusion. The developed technology of fragmentation of the lens nucleus reduces the time of phacoemulsification, reduces the ultrasound load, causes a smaller loss of cells at the back of the corneal epithelium, reduces the possible complications of the iris and ciliary body, which increases the efficiency of surgical treatment of cataract in patients with PEX.
CLINICAL & EXPERIMENTAL RESEARCH
Purpose: to study the relationship between the optic nerve structural changes and the electrophysiological parameters of visual analyzer in the early diagnosis of primary open-angle glaucoma (POAG). Patients and methods. 68 people took part in the study. 48 patients (56 eyes) were diagnosed with ophthalmic hypertension, suspected glaucoma (age ranged from 35 to 67 years, the average age was 51 years) and 20 healthy subjects (40 eyes) who entered the control group (age 32 up to 63 years, the average age is 47 years). All patients underwent standard ophthalmologic examination, multifocal electroretinography (mEPHRG), confocal scanning laser ophthalmoscopy (KSLO), electrophosphhenes and CFCs. For all types of analysis of mEPHR indices (by rings, quadrants and 3D), normal topography and density of the biopotential of the central region of the retina were recorded in patients with suspected glaucoma. The indices of the electrosensitivity of the inner layers of the retina, the conductivity of the axial fasciculus of the optic nerve, and CFSC also corresponded to normal values. Analysis of CCEA results showed a significant decrease of NRF volume of and the thickness of the retinal layer of nerve fibers compared to the control group, while in the group of patients with suspected glaucoma in 71 % of cases, the decrease of indicators correlated with the abnormalities in the static perimetry that was carried out earlier. Conducted morphometric studies confirm the fact that the decrease in the volume of IUU and SNV begins at the early, preclinical stage of glaucoma, and this in patients with ophthalmic hypertension can provide valuable information on the early diagnosis of POAG.
Purpose: to study the morphological characteristics of the macular zone using optical coherence tomography to assess its development in congenital cataract. Patients and methods: a comprehensive ophthalmological examination was performed in 147 children (269 eyes) aged 1 to 15 years, including, along with traditional methods, optical coherence tomography on the Spectralis HRA + OCT instrument, Heidelberg Engineering. Of these, 193 eyes were with pseudophakia after the removal of congenital cataracts in children aged 2 months to 14 years, 18 eyes with aphakia after the removal of congenital cataracts in children aged 2 months to 11 years, 20 unoperated eyes with partial forms of congenital cataracts and 38 paired conditionally healthy eyes in children with unilateral congenital cataracts. Visual evaluation of linear tomograms, measurement of 5 parameters of the central zone of the fundus and calculation of the macular index were performed. Results: various features of the macular zone were revealed: changes in the macular contour, lamellar structure of the retina, thinning of the choroid, and elements of epiretinal fibrosis. Evaluation of retinal differentiation with the help of a macular index, calculated on the basis of morphometric characteristics, revealed its violations in 52.8 % of cases, which was not always revealed in the visual analysis of tomograms. The best morphometric parameters of the central zone of the fundus are noted in the eyes with pseudophakia in comparison with aphakia (p < 0.05). Conclusion: there is a variability in the state of the macula. In patients with congenital cataracts. Better indicators of the central zone of the fundus in front of the eye with pseudophakia in comparison with aphakia justify the feasibility of performing surgical treatment of congenital cataracts simultaneously with the implantation of the intraocular lens, including in infants. Thinning of the choroid in the subfoveiolar zone with congenital cataract may indicate a violation of trophism and exert additional influence on the physiological development of the macular zone.
Numerous recent studies indicate that the key mechanism for the development of central serous chorioretinopathy (CSR) is damage to retinal pigment epithelium (RPE). At the same time, the reports appeared in recent years indicate that an equally important link in pathogenesis is the disturbances of the choroidal blood flow. Thus, the introduction into clinical practice of optical coherence tomography in the angiography (OCTA) mode made it possible to visualize the retinal and choroidal vessels taking into account their segmentation, which opens up prospects for studying chorioretinal blood flow in the CSR. Purpose: to reveal the regularities of the change in the choroidal blood flow in patients with SCR according to the OCTA data, to assess their informativeness and role in the pathogenesis of the disease. Patients and methods: 26 patients with SCR aged 35–54 years were examined. To assess the chorioretinal blood flow, optical coherence tomography of the retina is included in the angiography mode in the scope of the diagnostic examination. Results and discussion: It has been revealed that the number of large vessels in the immediate vicinity of the RPE is increasing in SCR, i.e. the vessels move towards the retina in the direction of the least resistance. Disturbance of the hierarchy of the vasculature is an important fact, allowing to speak about pronounced hemodynamic disorders. Disturbance of the topography of large-caliber vessels is accompanied by the formation of a characteristic vascular pattern. The revealed predominance of the reticular pattern of large vessels in patients with CSR is more likely due to the presence of a significant number of bifurcations and anastomoses, as well as an increase in the proportion of crossed vessels. This may be accompanied by an increase in total vascular resistance. Consequently, the hydraulic resistance can increase at these sites, a turbulent blood flow occurs and the permeability of the vascular wall increases. Correspondence between changes in RPE and choriocapillaries was established. Taking into account that the RPE detachments from 450 to 780 (on average 515 ± 72.3) μm, revealed in the projection of the altered choriocapillaries, have comparable sizes with the value of one vascular lobe (515 × 450) μm, one can speak of a local lesion of choriocapillaries and RPE within one arteriocentric lobules. Conclusions: The revealed changes in regional blood flow are progressive and can be used as classification and prognostic criteria for choroidal dysfunction.
Purpose. to study the effect of physical exertion on the visual analyzer and the general functional state in children and adolescents who regularly engage in sports. Material and Methods. The study was conducted in a group of 600 children and adolescents aged from 8 to 17 years who were divided into two groups of 300 people: the I group — “athletes” (regularly engaged in sports), the second group — “schoolchildren” (those engaged in sports less than 3 hours per week). Each group was divided into two subgroups of 150 people — “emmetrops” and “myopes”. The parameters of visual acuity, axial eye length, indices of regional eye hemodynamics were evaluated. Results. After 12 months, the group “athletes” showed a statistically significant decrease in refraction on average by 0.14 ± 0.18 on the background of stable visual acuity. In the group “schoolchildren” there was a significant reduction in visual acuity without correction by 0.06 ± 0.19 (p = 0.004) and refractive indices by 0.35 ± 0.61 (p < 0.001) on the average. After 12 months, among the emmetrops, myopia was diagnosed in 6 % of cases in the “athletes” group and 10 % in the “schoolchildren” group. Among the “myopes” in both groups there was a significant increase in the body mass index and the number of persons with impaired functional state of the musculoskeletal system in the form of a violation of posture and shape of the foot in comparison with the “emmetrops”. Сonclusion. Regular physical activity can be considered as one of the factors preventing the development and progression of myopia, and functional disorders of the musculoskeletal system in the form of violation of posture and shape of the foot and excessive body weight — as possible risk factors for the development of myopia.
Purpose: creation of working classification of morphologic variations of postoperative lens capsule opacity after Micro-Invasive cataract surgery. Material and methods. Morphologic study of the lens capsule (LC) has been conducted on 4 artiphakic cadaveric eyes. A specimen of an isolated anterior lens capsule, obtained during the repeated operation with changes characteristic for anterior capsular contraction syndrome has been studied too. The obtained specimens have been researched with the method of semithin sections. Results. The analysis of the morphologic cadaveric LC specimens revealed the polymorphism of secondary cataract (SC). Besides well known “classic” SC forms, which were caused by fibroplasias processes or pseudo-regeneration a new type of postoperative LC opacity not represented in the available literature before has been revealed. The given variant of opacities was called “pseudo-hyaloid” form and characterized by the absence of clear LC borders, changes of its normal structure, the appearance of loose fibrillar structure with microslit spaces and exfoliations, that possibly was the consequence of acustic cavitation, arising in the result of ultrasonic effect. As a result the LC lost characteristic for it the role of the dense bed and made impossible adhesion and migration on its changed surface the proliferative fibrocellular elements characteristic for “classic” SC forms. The microscopy results of the isolated anterior LC specimen in the area of capsulotomic aperture showed the presence of altered abundant loose fibrillar tissue with microporous structure and expressed forming of folds. Making layers of fibrous tissue exceeded the thickness of the normal anterior LC in 10 and more times and considerably reduced the diameter of capsulotomic aperture. Conclusion. The variety of postoperative LC opacities confirmed by the results of morphologic studies afforded to suggest a new working classification in which all possible morphologic variants and the stages of the secondary pathologic changes forming of anterior LC. The suggested classification is convenient for the understanding and must promote to make a right algorithm in the choice of optimal and safe technology of laser reconstructive interventions.
The purpose of the study was to examine the effect of the intraocular lens (IOL) position in the probability of occurrence of the phenomenon of light reflection from its surface and to justify the method of its reduction from the standpoint of the optics laws and eye anatomical parameters. Methods. Based on the laws of physical optics, the reflection of light from the surfaces of the IOL was calculated. The phenomenon of light reflection from the IOL was analyzed, in particular, influence such factors as the lens position in the eye and pupil diameter on its occurrence. Results. It was found that with increasing of distance from the iris to posterior chamber IOL, the angle of appearance of the phenomenon of light reflection from the lens decreases significantly, with the most significant change (angle narrowing from 80° to 19°, i.e., 4.21 times) with increasing of the distance from 1 to 3 mm, which is quite achievable at the present stage of intraocular correction. It was shown that the pupil diameter is less influences by appearance of the phenomenon of light reflection from the lens: it is significant only at a minimum distance from the iris to the IOL (the position of the standard posterior chamber IOL) and insignificant when the IOL is removed from the iris. The obtained results demonstrate the optimality of the method for preventing the appearance of the phenomenon of light reflection from the IOL by removing the intraocular lens from the iris at a distance corresponding to the position of posterior capsule of native lens. Conclusions. In this study, on the basis of the laws of physical optics and mathematical calculations, the leading role of such factor as the IOL position in the eye in appearance and intensity of the phenomenon of light reflection from the lens is substantiated for the first time. The proposed method for reducing the appearance of the phenomenon of light reflection from the IOL, which manifests itself in the form of glare in the eye, visible to others, on the basis of increasing the distance from the iris to the IOL is the optimal solution to the important problem of improving the quality of life of patients with pseudophakia.
PHARMACOLOGY
Purpose: To evaluate effectiveness and safety of cataract surgery pharmacological support (which include 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) in glaucoma patients. Patients and Methods: Standard ophthalmological examination, subjective discomfort level evaluation, tear film break up time, tear meniscus height measurement, index of xerosis, evaluation and ocular surface condition photoregistration were performed in 40 II «A» primary open-angle glaucoma patients, receiving hypotensive therapy, before and after phacoemulsification (Ph). All patients in the postoperative period received instillations: 0.5 % levofloxacin (4 times a day, 7 days), 0.1 % dexamethasone (3 times a day, 7 days), 0.09 % bromfenac (once a day, 30 days) and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (3 times a day, 30 days). Control points were: examination before Ph, on 1, 7 and 30 days after Ph. Results: None cases of infectious or inflammatory surgery complications were recorded. The SD level was significantly increased on the 1 and 7 days after Ph, by the 30 day the SD level was significantly decreased, compared with a state on the 1 and 7 days. On the 1, 7, 30 days after Ph TFBUT significantly decreased. By the 30 day after Ph the TFBUT was significantly increased in compare with 1 and 7 days after operation. TMH changes after Ph had multidirectional character and in general were not significant throughout the observation, with a tendency to increase on the 1 and 30 days after surgery and to decrease on the 7th day. IX dynamics in compare with a state before Ph was not significant in all control points with a tendency to its increase on the 1 and 7 days after operation and to decrease on the 30th day. In general, pharmacological support of Ph was assessed by all patients as comfortable, there was no intolerance. Conclusion: The cataract surgery pharmacological support in glaucoma patients (including 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) showed: high efficiency (in prevention of infectious and inflammatory complications); safety by influence on the ocular surface; comfort of use.
Objective. To assess the dynamics of structural-functional markers in patients with combined pathology: primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD) with the background of lutein-containing drugs at long-term follow-up. Patients and Methods. The period of research was from November 2016 to January 2018; A parallel prospective study of patients (88 eyes), mean age 67.81 ± 8.41 (M ± σ); 67.64 (63.14; 73.08) (Me, Q25%, Q75%) years with combined pathology POAG and AMD (AREDS I and II). Patients were divided into 2 groups, the first group — a study group received Retinorm, by 1 capsule 3 times a day during a meal for 1 year, a second control group of 17 patients (32 eyes) did not receive lutein-containing medicines during the observation period. The study group consisted of 29 patients (55 eyes). There were 7 males and 22 females among them. The control group consisted of 19 patients (33 eyes), 2 males and 17 females among them. Visual acuity, standard automatic computer perimetry, optical coherence tomography, determination of spatial contrast sensitivity was carried out in all patients at the beginning of the study and after 1 year. Results. The maximum correlated visual acuity (MCVA) according to the table ETDRS increased in the study group and decreased in the control group, 95% the confidence interval for the changes in the MCVA: 0.1813636; 1.018182; 1.927273 и –3.878788; –2.393939; –0.8477273 (optotypes), respectively (W = 499.5; p = 0,0002919). Statistically significant changes in the thickness of the layer of nerve fibers of the retina (RNFL) neither in the middle nor in the sectors was revealed, and the thickness of the retina in oval foveal zone by sector: upper, temporal and lower statistically significantly decreased in the control group, while remaining unchanged in the observation group (р < 0.05). Spatial contrast sensitivity (SCS) after 1 year of use Retinorm remained at the same level in the control group, while there was a statistically significant increase in spatial contrast sensitivity in the main group, especially at high spatial frequencies is observed (р < 0.05). Conclusion. The results of the study indicate a positive effect of Retinorm used for 1 year. It was reflected in the improvement visual acuity in the distance, improvement of spatial contrast sensitivity, especially at high spatial frequencies, and the preservation of structural retinal indices both in the foveal zone and peripapillary.
HEALTH CARE
The frequency of myopia reached 26 % among of school graduates in 2000. In case of graduates from gymnasiums and lyceums — 50 %. The share of severe form of myopia 10–12 %. A pilot study was conducted. The prevalence of myopia was estimated in schoolchildren of 1, 5 and 11 classes in some Russian regions (Moscow, St. Petersburg, Igevsk, Ivanovo). Objectively cycloplegic refraction was studied in 3659 schoolchildren. During the entire period of being at school emmetropia was the most common type of refraction. In 5 and 11 classes myopia was more often refractive errors. The prevalence of myopia among 1th classes schoolchildren was 2.4 %, among 5th classes — 19.7 %, 11th classes — 38.6 %. In children studying in lyceums the prevalence of myopia was significantly higher (p < 0.01). Already in the 1 classes of gymnasiums and lyceums myopic children were 7.5 %, while in regular schools only 1.4 %. In 11 classes of lyceums the share of myopic children was 50.7%, in regular schools it was 30.9 %. This confirms the influence of education on the prevalence of myopia as an additive factor. The study of the myopia prevalence should be continued in different regions and municipalities to the subsequent development the rational programs for prevention of development and the progression of myopia in school.
PATENTS
ISSN 2500-0845 (Online)