Purpose:to evaluate, using transpalpebral rheoophthalmography (TP ROG), the effectiveness of sclera-strengthening and trophic treatment of progressive myopia with a new biologically active chitosan-containing transplant.Patients and methods. 40 children and adolescents with moderate or high progressive myopia, averagely aged 12.6 ± 0.38 years, were examined after receiving low invasive sclera-strengthening surgery on one eye with a biologically active chitosan-containing transplant. The initial refraction of the operated eye was — 6.25 ± 0.23 D, while that of the fellow eye was — 5.85 ± 0.28 D. The yearly gradient of myopia progression averaged 1.10 ± 0.04 D. Hemodynamic parameters were measured using TP ROG) prior to intervention, then 1, 6 and 12 months after intervention. At the same time points, scleral acoustic density (SAD) was determined by analyzing tissue histograms obtained with a multipurpose ultrasound device, VOLUSON 730 Pro «GE».Results. One year after sclera-strengthening treatment, a 4.4-fold reduction of myopia progression rate on the operated eye was noted, supplemented by a 2.2-fold reduction of same on the fellow eye. Stabilization of refraction was accompanied by an increase of SAD: 6 months after the surgery, SAD was averagely 19.7 conventional units higher than the original figure in the posterior pole of the operated eye, and 16.2 conventional units higher in the equatorial area. One year after the surgery, the figures were, respectively, 15.9 (p < 0.05) and 14.0 conventional units (p < 0.01). The rheographic index of TP ROG increased with regard to the initial value by 139 % after one month, by 69.8 % after 6 months, and by 34.6 % after 1 year. On fellow eyes, the index also tended to increase: by 123.3 % after 1 month, by 65.2 after 6 months, and by the end of the follow-up period it exceeded the original value by 28.7 %, which is an evidence of a pronounced trophic effect of sclera-strengthening myopia treatment with chitosan not only on the operated eye but also (to a lesser extent) on the fellow eye.Conclusion. TP ROG is an effective evaluation method of sclera-strengthening treatment of progressive myopia. This method can also be used to study eye hemodynamics in a variety of ophthalmic pathologies, including those managed in pediatric clinical practice.
A review of modern literature on the diagnostic algorithm of bronchial asthma and a detailed examination of all its stages is presented. It is known that bronchial asthma is the most common form of the disease, prone to progression to more severe forms, but fraught with the development of exacerbations, even fatal. Often, general practitioners perceive bronchial asthma as a manageable, understandable disease, for the successful treatment of which it is enough to identify and isolate the allergen, as well as prescribe therapy. Understanding the mechanisms of development of bronchial asthma helps to increase the effectiveness of the diagnosis and treatment of asthma, preferably taking into account the phenotype. Determining the phenotypic characteristics of bronchial asthma is a requirement of the time, because personalized medicine does not yet require the creation of a separate drug, diagnostic or prophylactic method for each individual patient, but it requires the selection of patients (allocation of subpopulations / clusters / phenotypes of bronchial asthma) that are most responsive to a particular drug, a method for diagnosing or preventing a disease. The essence of phenotyping in medicine is the optimization of diagnosis, treatment and prevention. The central and most studied links of the pathogenetic mechanism and its variants of development are described, phenotypes of bronchial asthma are discussed, as well as options for basic and targeted therapy of bronchial asthma. The necessity of studying personalized therapy and flexible dosing of drugs used in the treatment of bronchial asthma is emphasized.
SummaryPurposeTo demonstrate the role of ultrasound biomicroscopy (UBM) for the diagnosis of anterior segment pathology.MethodsUBM was performed in 7 patients with corneal opacity (6 eyes) and with anterior chamber (AC) opacity (1 eye).ResultsIn first case with total hyphema UBM demonstrated thickening of the iris. Second case with post‐contusional corneal edema and hyphema demonstrated signs of iridodialysis and cyclodialysis. Third patient with central corneal scar had a signs of intraocular epithelial proliferation. With UBM the epibulbar cyst extension into anterior chamber was confirmed in fourth clinical case. In patient with fungal corneal ulcer (fifth case) UBM demonstrated central corneal defect and anterior chamber opacities. Lipodermoid was found in sixth clinical case. UBM helped to confirm that the sclera was not involved. In seventh case with corneal nebula after ocular burns UBM demonstrated iridocorneal adhesion and retrocorneal fibrous membrane. UBM results in all clinical cases determined tactics of treatment.ConclusionsUBM is a safe and effective diagnostic tool in the management of eyes with disorders of the anterior segment especially when visualisation is limited and multiple traumatic injures are involved.
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