bluuebunny/crossref_metadata_2025 huggingface dataset:
Provisions of Using Chemical Drugs and their Derivatives in Islamic Jurisprudence
Authors: Matar Mohammed
Published: April 2023

ABSTRACT

         Studies have shown that the use of chemical medications and their derivatives is prohibited because they result in self-killing and self-destruction. In fact, with the growth of chemical pharmaceuticals and their derivatives in recent times, worries have spread across the whole population. Islam has been keen to preserve the soul and the mind, physically and psychologically, in light of God's prohibition on killing the soul and the establishment of the death penalty. This is done in order to protect man from the evils of himself and to shield society from drug users, who pose a threat to other members of society. As Islamic Sharia's teachings and goals are all-inclusive, timely, and relevant to all concerns, they came with the ban of alcohol as one of many other items that are prohibited because they cause drunkenness and insanity. According to this, it is prohibited and unacceptable to use chemical medications and their derivatives. Just as alcohol was prohibited due to the serious damage it caused and the effects of its intake, so was the use of chemical drugs.
Information Security's Place in the National Security System: Actual Problems of Information Law
Authors: Duben Andrei  Kirillovich
Published: April 2023

The work is devoted to the study of information risks in the national security system. Today's challenges and risks in the information sphere force us to look for new relationships between industries to improve the quality of life and reduce information threats. The presented information threats require identification and leveling in the future if such external restrictions arise. The article reveals the role and place of information security in the national security system of the country. This paper discusses the basic concepts of information security in the system of ensuring the national security of Russia, as well as the types of threats to information security, methods and means of combating these threats. This article examines the problem of legal provision of information security. According to the results of the study, the author concludes that the information policy of the Russian Federation is the regulator of public and private legal relations, through which the strategic objectives of the state are realized. Information security, as a type of national security, by its regulatory influence permeates all the diversity of social relations arising in the process of human and state life. It follows from this that the legislator should improve not only the norms of a public-legal nature containing prescriptions and prohibitions, but also private-law norms, the construction of which is based on permissive (dispositive) regulation.
Aspectos da fisiopatologia da COVID-19 na infância
Authors: Monteiro Alessandro Trevisan , Savian Cristiane Medianeira , Costenaro Regina Gema Santini , Santos Bianca Zimmermann dos
Published: April 2023

Objetivo: Identificar as produções científicas desenvolvidas sobre a fisiopatologia da COVID-19 na infância. Revisão bibliográfica: O número de casos confirmados da COVID-19 entre crianças é pequeno quando comparado às outras faixas etárias. A maior parte dos casos, entre crianças, permanece assintomático. As crianças com COVID-19 apresentam sintomatologia mais leve e menor número de hospitalização e complicações com risco de vida. Tem sido descrito casos graves da doença como a Síndrome Inflamatória Multissistêmica em crianças. Compreender a invasão viral por meio da proteína Spike, células epiteliais ACE 2 e pela serina protease-2 transmembrana, pode explicar a diminuição de casos pediátricos. Esse grupo possui diminuição destas proteínas, contribuindo também para entender o funcionamento dos sinais e sintomas pediátricos. Quanto a transmissão, acreditava-se que as crianças, devido a sua sintomatologia mais branda, contribuíssem pouco para sua proliferação, porém atualmente há evidências de que elas podem sim espalhar a infecção. Considerações finais: É provável que as crianças tenham diferenças em suas respostas imunes ao vírus. Ao abranger esta população em novas pesquisas científicas, talvez seja possível aumentar o preparo para enfrentar novas mutações emergentes tanto da SARS-CoV-2, como de outras patologias virais, transcendendo novas endemias e pandemias, preparando-se e protegendo o futuro desta população.
Osteossíntese definitiva ou fixação externa: relato de caso de uma quase amputação traumática de membro superior
Authors: Vieira Tieslivi da Silva , Cianciarulo Eduardo Bracco , Andrade Guilherme Alves , Lanzarin Leonardo Depiere , Möller João Victor da Silveira , Lara Paulo Henrique Schimidt
Published: April 2023

Objetivo: Relatar um caso de um paciente com fratura exposta de cotovelo conduzida com tratamento cirúrgico definitivo na abordagem inicial em um cenário limítrofe para possível amputação ou fixação externa para controle de danos locais. Detalhamento do caso: Masculino, 36 anos, vítima de acidente automobilístico.  O paciente apresentava uma lesão extensa de partes moles e exposição óssea, nervosa e vascular.  Foi realizado o diagnóstico de fratura de cotovelo através das radiografias, sendo conduzido a fixação definitiva das fraturas com placas e parafusos. Posteriormente, fez-se o seguimento com procedimentos adicionais a fim de realizar o tratamento para rigidez residual pós-traumática. Após 2 anos de seguimento, o paciente alcançou um resultado amplamente funcional e encontra-se satisfeito com o desfecho atual. Considerações finais: O manejo desses casos complexos continua um desafio para a comunidade médica em geral e, principalmente, para os cirurgiões ortopedistas. Em algumas oportunidades, a primeira abordagem pode ser a única chance de salvação do membro do paciente mesmo quando o contexto é desafiador. Portanto, apresentamos um relato onde demonstramos um resultado aceitável nesse contexto a fim de encorajar os cirurgiões a sempre considerar  essa opção terapêutica.
A rare post-COVID neurological complication: Case report of peripheral axonal sensory neuropathy
Authors: Bembey Raghavi Abhilesh , Babu Ram
Published: April 2023

The present outbreak of Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), a “novel coronavirus” with neurotropic potential, has presented with multiple cases of neurological manifestations also. SARS-CoV-2 infection is found to be associated with an increased incidence of diverse neurological manifestations such as hyposmia/anosmia, encephalopathy and encephalomyelitis, ischemic stroke and intracerebral hemorrhage, and neuromuscular diseases involving both central and peripheral nervous system. People with these severe complications were most likely elderly with medical comorbidities, especially hypertension and other vascular risk factors. However, in our case a 35-year-old young healthy man developed severe post-COVID neuropathy debilitating his daily activity further requiring rehospitalization. Our patient had developed severe SARS-CoV-2 pneumonia, with a computed tomography severity score of 18/25, needing non-invasive ventilation support, and intensive care unit care for a week, thereafter recovering well without complications and being discharged on room air. He had to be readmitted after 3 days in view of severe bilateral leg pain, being described as “pain crisis.” He was evaluated, a neurologist was involved in the case, with nerve conduction veloci (NCV) lower limbs revealing an axonal sensory neuropathy, which was treated with corticosteroid pulse therapy, gabapentin, and vitamin supplementation to which the patient responded well. Our case presented with pure sensory neuropathy post-COVID which is a rare presentation. The previous reports of treatment of SARS-CoV-2-associated neuropathy have also included corticosteroids and IVIG usually. Our patient improved with pulse therapy of corticosteroid and gabapentin. Thus, awareness and early treatment of peripheral neuropathy after SARS-CoV-2 is needed for good clinical outcomes.
A novel p.Leu197Pro homozygous variant in HSD3B2 as a cause of 46,XY DSD with hyperpigmentation in an infant
Authors: Yadav Borra Rajesh , Machiraju Aswini , Sruthi Navya , Ch Mounika Anitha , Ramesh Jayanthy
Published: April 2023

We report a novel missense variant of the HSD3B2 gene in a 46,XY child born to third degree consanguineous parents presenting with undervirilization and progressive hyperpigmentation. The steroid profile showed elevated concentrations of 17-hydroxyprogesterone, but normal androstenedione and testosterone. The adrenocorticotropic hormone was elevated. The direct DNA sequencing of the child revealed a new homozygous missense variant in the HSD3B2 gene, resulting in the amino acid substitution of proline for leucine at codon 197. We have described a hitherto novel HSD3B2 gene variant in an undervirilized male infant causing 3β-hydroxysteroid dehydrogenase 2 deficiency.
Comprehensive Overview of Congenital Adrenal Hyperplasia and its Genetic Diagnosis Among Children and Adolescents
Authors: Korula Sophy , Chapla Aaron , Ravichandran Lavanya , George Arun
Published: April 2023

The most common cause for congenital adrenal hyperplasia (CAH) is 21-hydroxylase deficiency (21OHD). This enzyme is encoded by the CYP21A2 gene which is highly homologous to its pseudogene CYP21A1P complicating the genetic analysis. We propose an algorithmic approach to genetic testing in 21OHD CAH utilizing multiple molecular techniques such as allele-specific polymerase chain reaction (ASPCR) and targeted gene sequencing to make it cost-effective. We recommend the classification of the common genetic mutations as Null and A–D, as established on functional enzyme studies. Pediatricians and pediatric endocrinologists need to be aware of the excellent genotypephenotype correlations established in the severe salt wasting CAH as highlighted in this review.
Midbrain hemorrhage presenting with isolated downward gaze palsy: A case report
Authors: Tsukada Atsushi , Yanaka Kiyoyuki , Ishikawa Eiichi
Published: April 2023

Background:

Diseases presenting with only downward gaze palsy are extremely rare particular in cerebral hemorrhage.

Case Description:

A 63-year-old man with no medical history developed a downward-dominant vertical gaze paralysis with a convergence disorder. Computed tomography and magnetic resonance imaging showed a small hemorrhage of 13 mm in diameter in the right midbrain tegmental area. The patient was conservatively treated. His symptoms showed a gradual improvement from upward gaze paralysis and convergence disorder followed by downward gaze paralysis. All symptoms disappeared in 3 weeks after the onset. The center of vertical eye movement was thought to be the rostral interstitial nucleus of medial longitudinal fasciculus (riMLF) and posterior commissure (PC).

Conclusion:

In this case, bilateral riMLF and PC were impaired, resulting in bilateral vertical ocular motility disorder with upward gaze paralysis. Brainstem hemorrhage rarely presents with vertical gaze palsy. Most are cerebral infarctions, and few are due to cerebral hemorrhage. This case was important for better understanding the pathophysiology of an ocular motility disorder. We also summarized the characteristics of isolated vertical gaze palsy caused by cerebral hemorrhage.
Idiopathic spontaneous bilateral subdural hematoma in a 28-year-old male: A comprehensive literature review and case report
Authors: Algahtani Abdulhadi Y. , Alghamdi Abdulaziz M. , Ashqar Alaa , Basurrah Abdulaziz Abdullah , Alzahrani Moajeb
Published: April 2023

Background:

Subdural hematoma (SDH) is considered spontaneous in the absence of trauma history. It is a common presentation in the geriatric age group due to the many influential factors. Most cases have a known underlying etiology that explains the incidence, otherwise, they are considered idiopathic. We present a rare case report of idiopathic nontraumatic bilateral SDH with a literature review of similar cases.

Case Description:

A 28-year-old fit individual presented to the Emergency Department with a chronic history of severe headache and neck pain, associated with behavioral changes in the last 2 days. He reported that his symptoms started after lifting a heavy object 2 months ago; however, they became worse after a neck chiropractor therapy session. He is not on any chronic medications, and there was a negative history of trauma, seizure, hematological diseases, family history of neurological conditions, smoking, alcohol, or drug abuse with an unremarkable systemic review. A brain computerized tomography (CT) showed bilateral SDHs, for which he underwent bilateral mini craniotomies and drainage. The symptoms improved after surgery and the follow-up brain CT showed no recurrence.

Conclusion:

Idiopathic spontaneous bilateral SDH in the adult age group is an extremely rare pathology and the literature review only revealed three similar cases. With the absence of any pathology that would explain the presentation after extensive investigations, we hypothesized that a sudden rise in vascular pressure was the underlying etiology, especially with the fact that the symptoms became unbearable after the neck chiropractor therapy session.
Clinical analysis efficacy of anatomical attachment of foveolar retina in vitreoretinal surgery for penetrating macular holes
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Mashchenko N.V. , Kolenko O.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation,   Far-Eastern State Medical University, Khabarovsk, Russian Federation,   Postgraduate Institute for Public Health Workers, Khabarovsk, Russian Federation, Zhigulin A.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Lebedev Y.B. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Malyutin I.I. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation
Published: April 2023

Purpose. To compare the anatomical and functional results of various techniques macular hole (MH) closure. Material and methods. 24 patients (age from 67 to 81 years; 6 men and 18 women): stage III MH, complete detachment of the posterior hyaloid membrane. MH sizes were from 427x202 to 1392x758 µm. Initial best-corrected visual acuity (BCVA) were from 0.03 to 0.2. Endovitreal intervention 27G with removal of the posterior hyaloid membrane, complete membrane peel was performed. In 18 patients, tamponade was performed with silicone oil, in the remaining 6 patients – with air. 2 groups were formed, comparable in age, sex, MH diameter. In the 1st group (12 patients) vacuum massage was performed, in the 2nd group (12 patients) – partial membrane peel with inverted internal limiting membrane flap technique. Results. All surgery perfomed without complications. In 18 eyes with silicone oil tamponade, all MH were completely closed, BCVA was from 0.15 to 0.5. In 2 of 3 eyes of the 1st group with combination of vacuum massage and pneumotamponade, incomplete closure of the edges of the MH with residual defects 112 µm and 84 µm, respectively, was noted. BCVA ranged from 0.1 to 0.2. In the third case of combination of vacuum massage with pneumotamponade, the MH completely closed, the BCVA increased from 0.2 to 0.6. In all 3 eyes, using the inverted flap technique and pneumotamponade, the MH were completely closed, the BCVA ranged from 0.45 to 0.55. After 1 month after ended of silicone oil tamponade in all 18 patients, the MH were closure, BCVA values increased from 0.25 to 0.5. Conclusion. After a month of follow-up, better anatomical results of complete MH closure were shown by the inverted flap technique in combination with air or silicone oil tamponade. After silicone removal, complete MH closure occurred in 10 eyes of the 1st group and 12 eyes of the 2nd group. In the future, the terms of dynamic observation of these patients will be continued for more objective assessment of the long-term effectiveness of both methods. Keywords: macular hole, vacuum massage, vitreous tamponade
Сlinical case of dirofilariasis in the vitreal cavity
Authors:   N.I. Pirogov National Medical Surgical Center, R.R. Fayzrakhmanov ,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, V.A. Bogdanova ,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, M.S. Lebed'ko ,   N.I. Pirogov National Medical Surgical Center, E.D. Bosov ,   N.I. Pirogov National Medical Surgical Center,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center
Published: April 2023

Relevance. Dirofilariasis (Dirofilariasis, from Lat. «diro, filum» – «evil thread») is a disease that belongs to the group of transmissible zoonotic biohelminthiasis. Man is the facultative host of dirofilariae. That is why the survival rate of larvae in the human body is very low. Up to 50 % of cases of dirofilariasis registered in humans are due to dirofilariasis of the visual organs. The intraocular form is extremely rare. The true incidence of dirofilariasis in humans is unknown, due to the fact that there is no official registration. Dirofilariae widely circulates in the natural environment, but at the moment there are no systematic measures to identify and deworming infected animals. In addition, due to insufficient awareness of doctors working in the practical healthcare system, this pathology is often detected and treated under various diagnoses of non-parasitic etiology. Perpose. To present a clinical case of a method of surgical removal of dirofilariasis in the vitreal cavity. Material and methods. The article presents a rare clinical case of intraocular invasion of dirafilariasis, and also describes the surgical tactics of helminth extraction. Results and discussion. The patient underwent surgical treatment in the volume of vitrectomy with the removal of the parasite with positive functional results. Surgical intervention is a radical and the only possible treatment in the case of intraocular invasion of dirofilaria. Conclusion. It is important to understand that localization of dirofilaria in the vitreous cavity, without radical surgical treatment, can lead to threatening consequences of vision loss. And the increase in the frequency of cases of dirofilariasis indicates the need for doctors to be wary of the differential diagnostic approach in identifying pathologies. Keywords: dirofilaria, helminthiasis, vitreoretinal surgery, vitreous, intraocular invasion
Search for biomarkers of diabetic retinopathy and its complications in the vitreous body and intraocular fluid
Authors:   «K+31» Clinic, Moscow, Biletskaya V.A. , Lipatov D.V. ,   Endocrinology Research Centre, Moscow
Published: April 2023

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to formidable comorbidities that significantly affect the lives of patients. At the beginning of 2021, there were more than 537 million ¹ people with DM in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of diabetes affecting the organ of vision. The formation of moorings on the retina, the formation of traction syndrome, hemorrhagic complications, retinal detachment and hemophthalmia, as well as neovascular glaucoma (NG) is a manifestation of the terminal stage of proliferative DR. NG is considered one of the most severe terminal forms of refractory glaucoma, which is steadily progressing, leading to disability and impaired social adaptation [1]. The main method of treating diabetic complications in the posterior segment of the eye is vitrectomy, and in the event of NG, implantation of the Ahmed valve due to the ineffectiveness of conservative therapy. At the same time, one should not forget about multiple complications both during the operation, and in the early and late postoperative periods. To date the pathogenesis of DR development remains unexplored. Apparently, it is based on hyperglycemia, chronic diffuse chorioretinal hypoxia and ischemia of the corresponding structures and tissues. These unfavorable factors trigger a pathogenetic cascade of reactions that cause the release of various angiogenic factors and cytokines. Many researchers have shown the role of the immune response in the development of proliferative DR. This was the reason for the study of the local production of various cytokines and growth factors in patients with DM, proliferative DR and NG. Keywords: diabetes mellitus, diabetic retinopathy, neovascular glaucoma, biomarker, cytokines
Analysis of the state of ophthalmological health of conscripts in the Military Commissariat of the Leninsky and Sverdlovsk administrative districts of the city of Irkutsk, Irkutsk region
Authors:   Regional State Budgetary Healthcare Institution «Irkutsk City Hospital No. 6», Vidyakina N.V.
Published: April 2023

The article analyzes the medical examination of 7372 citizens when conscripted for military service in the military commissariat of the Leninsky and Sverdlovsk administrative districts of the city of Irkutsk, Irkutsk region for 2021–2022. In the structure of fitness for military service of persons of military age for 2021 and 2022, according to the articles of the schedule of diseases, article 34 (refraction and accommodation disorders) takes 1st place, article 31 (retinal detachment) takes 2nd place, and 35 (blindness, low vision, color vision abnormalities) takes 3rd place. Every second young man of military age has a violation of refraction and accommodation, in which myopia (myopia) plays a leading role. A combination of ophthalmic nosologies was found in 530 (13.6 %) conscripts. Keywords: ophthalmological health, medical examination, military service, conscript, ophthalmological nosology
Clinical features of the diagnosis of choroideremia
Authors:   Ophthalmology Center «Vision», St. Petersburg, Gordeeva M.V.
Published: April 2023

Choroideremia is a very rare inherited retinal disease, which is sometimes misdiagnosed. Clinical features of this disease are similar to those of other hereditary retinal dystrophies, especially retinitis pigmentosa. That is why even retinal specialists may not have experience with this condition. It prolongs the time to correct diagnosis and affects subsequent patient management. There is no treatment or cure for choroideremia but it is possible that gene therapy will become available in the near future. We present a case of choroideremia in a 22-year-old male patient who has been suffering from poor night vision and a progressive narrowing of the visual fields since early childhood and was misdiagnosed with retinitis pigmentosa. Keywords: сhoroideremia, inherited retinal diseases
Unique Pathological and Physiological Angiogenesis of ROP in Safety Aspects of Selective Anti-VEGF Therapy
Authors:   Voronezh State Medical University named after N.N. Burdenko, Voronezh, Kovalevskaya M.A. , Evdokimova О.A. ,   Voronezh State Medical University named after N.N. Burdenko, Voronezh,   Federal Medical Biophysical Center of the Federal Medical Biological Agency (FMBA) Russia, Moscow, Rascheskov А.Y. ,   Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, Kazan
Published: April 2023

ROP in the developing retina of premature infants is unique because of the coexistence of physiological and pathological angiogenesis. The type of structure of the vascular nodes is the way to understand the selective treatment of ROP. Purpose. Identification of criteria for the selective ROP treatment choice using the type of pathological vasculogenesis. Material and methods. The study included 279 patients with ROP – 1 group (stage I), 152 (304 eyes); group 2 (stage II) – 45 (90 eyes); 3 group (III stage) – 8 (12 eyes); group 4 (IVA stage) –7 (8 eyes); 5 group (posterior aggressive ROP) – 7 (14 eyes); group 6 (immature retina) 60 (120 eyes) – control; 231 (188 eyes) patients with ROP referred for surgical treatment, divided into subgroups before and after lasercoagulation of the retina. Fractal dimension (Df) and complexity of vascular system (СVS) on wide-field images were assessed. Results. In the group before treatment Df 1.4374 ± 0.03, CVS 2.8 ± 0.14, in the group after treatment Df 1.3756 ± 0.03, CVS 2.3 ± 0.21. According to the morphometric data of 12 images, Df (p = 0.004) and CCC (p = 0.02) values were statistically different in subgroups before and after treatment. Low values of Df (< 1.34) may indicate a more pronounced shift of angiogenesis towards pathological, since normally Df of the formed vasculature is 1.7. In this case, it is preferable to use anti-VEGF therapy. Conclusion. The Df and CVS are indicators are relevant parameters for evaluating the effectiveness of laser treatment in patients with ROP. Vascular patterns are unique for each post-conceptual age, CVS and Df are potential markers of the balance between pathological and physiological angiogenesis for the selective choice of ROP therapy. Keywords: retinopathy of prematurity, retinal laser photocoagulation, retinal vascular system, antiVEGF
Differential diagnosis of serpiginous choroiditis' forms as a key to treatment
Authors:   S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Poroshina M.A. , Unina M.A. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Pedanova E.K. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Gorshkov I.M. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Popov A.B. ,   S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
Published: April 2023

Purpose. To present a case report of serpiginous chorioiditis to perform the differential diagnosis for treatment. Material and methods. The patient, 33 year old, with a decrease of visual acuity. The comprehensive ophthalmologic examinations ware carried out, including the examination of best corrected visual acuity (BCVA), slit lamp indirect ophthalmoscopy, microperimetry, optical coherence tomography (OCT), OCT – angiography, fundus autofluorescence (AF). Results. During the examination the diagnosis was «OU Classical serpiginous chorioiditis with activity on the left eye. Subretinal neovascular membranes type 2 on the left eye». Conclusions. A non-infectious cause of serpiginous choroiditis was diagnosed. It was recommended the glucocorticosteroids' treatment. In this case, the process was complicated by the development of macular neovascularization, which required the administration of the angiogenesis inhibitors. Keywords: serpiginous choroiditis, tuberculosis, choroid, multifocal serpiginoid choroiditis
Features of the course of retinoschisis in patients of the Republic of Buryatia
Authors:   Irkutsk Branch of S. Fyodorov «Eye microsurgery» Federal State Institution of Ministry of Health of Russia, Saganova N.S. , Vandanova D.B. ,   Irkutsk Branch of S. Fyodorov «Eye microsurgery» Federal State Institution of Ministry of Health of Russia, Dobolova O.K. ,   Irkutsk Branch of S. Fyodorov «Eye microsurgery» Federal State Institution of Ministry of Health of Russia
Published: April 2023

It is known that the formation of retinoschisis occurs at any age, the senile form is more common, with the same probability in men and women. However, data on the nature of retinoschisis and their prevalence in patients over 18 years of age are fragmentary and unsystematic. Material and methods. A retrospective analysis of the occurrence of retinoschisis in patients older than 18 years was carried out. Results. Retinoschisis was diagnosed in 263 patients (372 eyes), which was 1.1 % of the number of examined patients. Group I included patients with uncomplicated retinoschisis, and group II included patients with complicated retinoschisis. In group I, bilateral changes were observed in 35 % of cases, and unilateral changes were observed in 65 %. In group II, bilateral changes were diagnosed in 44.5 % of cases, unilateral – 55.5 %. The distribution by type of ametropia was equal in both groups: 21.5 % of patients had myopia and emmetropia, in 57 % of cases – hypermetropia. According to the location in both groups, retinoschisis was diagnosed more often in the lower temporal quadrant in 58 % of cases. Conclusion. Retinoschisis is almost 2 times more common in female patients, mainly with hypermetropia and at the age of 50–70 years. In all types of ametropia, retinoschisis was localized in the lower temporal quadrant in 58 % of cases. Keywords: retinoschisis, retinal detachment, retinal hole, laser coagulation
The choice of tactics for the treatment of patients with chronic central serous chorioretinopathy complicated by pachychoroidal neovasculopathy
Authors:   Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Sidorova Y.A. , Erokhina E.V. ,   Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Kirilenko I.Y. ,   Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution
Published: April 2023

Purpose. To identify the initial OCT parameters that allow determining the tactics of treating patients with chronic central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. Material and methods. 73 patients (n = 73) with monolateral chronic form of central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. All patients were given intravitreal angiogenesis inhibitors as initial therapy. Depending on the results of treatment, the patients were divided into groups: control – 39 (n = 39) patients with positive dynamics for the treatment used, the main group – 34 (n = 34) patients with the lack of the desired effect from intravitreal administration of angiogenesis inhibitors, who were treated of combined treatment with the connection of subthreshold micropulse laser exposure. Initial OCT parameters which were different for both groups were being found. Results. In the main group, exacerbation of central serous chorioretinopathy had a greater impact than subactive choroidal neovascularization 1, that determined the positive result of combined treatment. Characteristic for the main group of OCT predictors were the thickness of the choroid more than 470 µm, the area of choroidal neovascularization type 1 less than 0.27 mm², the height of detachment of the neurosensory retina more than 310 µm. The initial OCT parameters, typical for patients in the control group, were the subfoveolar thickness of the choroid less than 470 µm, the area of the choroidal neovascular membrane more than 0.27 mm², and the maximum height of neurosensory retinal detachment less than 310 µm. In patients of this group, the prevailing element of the current clinical condition was the activation of type 1 of pachychoroidal neovascular membrane, which determined the favorable functional results of anti-VEGF therapy. Conclusion. During the study, OCT parameters were identified that make it possible to timely determine the tactics of treating patients with a chronic form of central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. Keywords: chronic central serous chorioretinopathy, pachychoroidal neovasculopathy, optical coherence tomography
Аge-related macular degeneration at policlinic appointment
Authors:   State Budgetary Healthcare Institution of the Republic of Bashkortostan, Ufa City Clinical Hospital No. 5, Altynbayeva G.R. , Shaykhutdinova O.V. ,   State Budgetary Healthcare Institution of the Republic of Bashkortostan, Ufa City Clinical Hospital No. 5, Asadullin V.F. ,   State Budgetary Healthcare Institution of the Republic of Bashkortostan, Ufa City Clinical Hospital No. 5, Talisov R.F. ,   State Budgetary Healthcare Institution of the Republic of Bashkortostan, Ufa City Clinical Hospital No. 5
Published: April 2023

Purpose. The article presents studies of 115 electronic records of patients who underwent anti-vasoproliferative therapy. Statistically significant differences between the genders of patients were revealed. Statistical analysis showed a direct relationship (r = 0.54) between the number of injections and the percentage of vascular stenosis in men, as well as high cholesterol in patients of 1st group, which consisted of women. In addition, the number, intervals between injections, frequency of administration and adherence to therapy were studied. Conclusion. AMD is most common among women. The most ideal is to carry out the injection on the day of the consultation in the hospital, after making a decision on the extension of treatment. This practice will increase patients' adherence to treatment. The most effective for both the doctor and the patient with retinal pathology is the use of drugs with prolonged action, more concentrated with the need for fewer injections during the year, which will reduce the waiting time for patients to receive antiangiogenic therapy, will increase the number of treated patients with a decrease in the number of hospitalizations. Keywords: age-related macular degeneration, anti-vasoproliferative therapy, intravitreal injections
Algorithm of managing patients with exudative form of age-related macular degeneration with resistance to one of the anti-VEGF drugs
Authors:   Scientific Research Institute of Eye Diseases named after. M.M. Krasnov, Budzinskaya M.V. , Plyukhova A.A. ,   Scientific Research Institute of Eye Diseases named after. M.M. Krasnov, Savochkina O.A. ,   Scientific Research Institute of Eye Diseases named after. M.M. Krasnov, Afanasiev M.A. ,   Scientific Research Institute of Eye Diseases named after. M.M. Krasnov, Sorokin P.A. ,   Clinic of eye microsurgery «Gazprom»
Published: April 2023

The exudative form of AMD can develop suddenly, leading within a few weeks or months to the death of photoreceptors, a sharp decrease in BCVA and persistent central scotoma. Despite significant progress in the treatment of neovascular AMD associated with the introduction of anti-VEGF drugs into clinical practice, a number of patients have an insufficient response or its absence with standard administration regimens, and sometimes a decrease in the therapeutic effect after repeated intravitreal injections [1, 2]. Purpose. To development management tactics for patients resistant to one of the anti-VEGF drugs. Material and мethod. This study included 25 patients with a diagnosis of exudative AMD who received Aflibercept in the treat & extend regimen for a year, without a significant effect (persistence of intraretinal, subretinal and/or fluid under RP). Patients were switched to brolucizumab. The mean maximum correctable visual acuity in patients treated with aflibercept before switching drugs was 0.41 ± 0.11. The mean number of injections during the first year in the aflibercept group was 7.1 and 6.8 after switching to brolucizumab. The maximum correctable visual acuity at the end of 1 year of treatment with brolucizumab was 0.47 ± 0.1. Before the start of treatment with aflibercept, the mean CRT was 435.2 ± 119.8, at the end of the first year of treatment 403.3 ± 115.9, before 1 intravitreal injection of brolucizumab 407.2 ± 119.3 and 1 year after the start of therapy 357.6 ± 111.4 (p = 0.042). A statistical difference was found between the preparations and the height of the detachment of the retinal pigment epithelium at the end of the first year of treatment. Changes in the height of detachment of the retinal pigment epithelium in 3 eyes (12 %) were not observed when changing the drug. A positive response to drug switching should be noted, although it cannot be overlooked that there are patients who are resistant to anti-VEGF therapy per se. Keywords: the exudative form of AMD, anti-VEGF drugs, neovascular AMD.
Role of nutraceutical in complex therapy of neovascular age-related macular degeneration against the background of anti-VEGF injections of aflibercept
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Danilova L.P. , Kolenko O.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation,   Far-Eastern State Medical University, Khabarovsk, Russian Federation,   Postgraduate Institute for Public Health Workers, Khabarovsk, Russian Federation, Storozhilova D.А. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Zhajvoronok N.S. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Shulga A.Е. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation, Emanova L.P. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, the Khabarovsk branch, Khabarovsk, Russian Federation
Published: April 2023

Purpose. Evaluation of efficacy of aflibercept (Eylea®, Bayer, Germany) in combination with nutraceutical Ophtholique® (Sentiss Pharma, India) in treatment of neovascular agerelated macular degeneration (nAMD). Material and methods. 32 patients (32 eyes) with nAMD aged 54 to 75 years, controls – 12 healthy people of same age and gender. Initially, best-corrected visual acuity (BCVA) averaged 0.32±0.05. Clinical and morphological features of nAMD was macular neovascularization (MNV): in 18 patients – type 1; 14 people – type 2. All patients underwent 3 intravitreal injections of aflibercept. Two groups were formed, comparable in terms of BCVA and central retinal thickness (CRT), duration and severity of macular changes, gender, age: the main group (17 patients) – treatment was supplemented with Ophtholique®; comparison group (15 patients) – Ophtholique® was not prescribed. Results. After 1 month after 3 intravitreal injections of aflibercept, all 32 patients had no signs of disease activity. The interval between injections was increased according to the protocol by 2 weeks. After 6 months in the main group, the BCVA increased to 0.61 ± 0.02 due to regression of MNV, a decrease of CRT to control values was noted. In the comparison group, BCVA increased to 0.47 ± 0.03, CRT decreased to control values in 8 out of 15 patients. In 7 patients, BCVA, on the contrary, decreased to 0.30 ± 0.01, while the CRT increased to 421.5 ± 5.2 µm. By 12 months all patients of the main group showed none resumption of MNV activity, complete reattachment of neurosensory retina and pigment epithelium, resorption of intraretinal cystic cavities was noted. In the comparison group MNV activity was noted in 5 eyes with decrease in functional parameters of the retina. Conclusion. Combination of aflibercept in Tread-and-Extend treatment regimen with oral administration of nutraceutical Ophtholique® take it possible to increase efficacy of treatment of nAMD. Keywords: neovascular AMD, anti-VEGF therapy
Posterior segment of the eyeball: clinical case of chronic central serous chorioretinopathy
Authors:   State Autonomous Healthcare Institution «Orenburg Regional Clinical Hospital named after V.I. Voynov», Orenburg, Naidenova S.I. , Lutsai E.D. ,   Federal State Budgetary Educational Institution of Higher Education «Orenburg State Medical University» under Ministry of Health of the Russian Federation, Orenburg, Astafyev I.V. ,   Federal State Budgetary Educational Institution of Higher Education «Orenburg State Medical University» under Ministry of Health of the Russian Federation, Orenburg
Published: April 2023

Central serous chorioretinopathy is most often found in able-bodied men of young and middle age. The aim of the study: to improve the quality and efficiency of medical care for patients with chronic central serous chorioretinopathy. A clinical example. Patient D., 46 years old, applied in May 2022. Treatment of this pathology is carried out according to the standards of specialized medical care in the field of ophthalmology, approved by the Ministry of Health of the Russian Federation. The clinical anatomy of the posterior segment of the eyeball is the basis for assessing various types of pathology, including chronic central serous chorioretinopathy. Diagnostics with visualization of layers in the area of the posterior segment of the eyeball is predominant among the research methods. Treatment in accordance with the standards of medical care leads to the restoration of the anatomical noma of the structures of the posterior segment of the eyeball. Keywords: posterior segment of the eyeball, human anatomy, central serous chorioretinopathy
Solar retinopathy in a 19–year-old man: a clinical case
Authors:   State autonomous healthcare institution «City Polyclinic No. 6», Ulan-Ude, Tatarnikova O.N. , Konovalova L.N. ,   State autonomous healthcare institution «City Polyclinic No. 6», Ulan-Ude
Published: April 2023

Due to the fact that Buryatia is a sunny region with high activity of UV rays, this pathology can occur quite often. Purpose. To evaluate the effectiveness of nutraceuticals and a complex of water-soluble polypeptide fractions with a molecular weight of no more than 10,000 Da (retinalamine) in the process of restoring photoreceptors and pigment epithelial cells. Material and methods. Observation and examination of one patient with a case of solar retinopathy using Retinalamine and nutraceuticals in the treatment. The patient underwent optical coherence tomography in Retina Map, Cross line, Radial line modes. Results. Against the background of treatment, after 12 days, visual acuity did not change, and according to OCT data, positive dynamics was noted: the infiltrate resolved, but slight deformation of the NPM and the line of photoreceptors remained. After a month, an increase in visual acuity with the preservation of distortion in the center, according to OCT data, the final defect (loss) of the photoreceptor line is determined. Against the background of the treatment, three months after the onset of the disease, we see the restoration of visual acuity to 1.0 and pigment epithelium, but a local defect of the photoreceptor line persists. Conclusions. Thus, against the background of treatment, a significant increase in visual acuity and elimination of the destruction of the pigment epithelium was established. Keywords: solar retinitis, macular OCT, photoreceptor line, pigment epithelium
Penetrating wound of the cornea with infringement of a foreign body in the cornea: a clinical case
Authors:   Regional State Budgetary Institution «Bratsk City Hospital No. 2», Bratsk, Yevdokimov V.A. , Drozdova K.M. ,   Regional State Budgetary Institution «Bratsk City Hospital No. 2», Bratsk
Published: April 2023

Injuries of the visual organ in Russia are one of the causes of visual disability and blindness. People of young, able-bodied age are most often affected. Purpose. To present a clinical case of treatment of a patient with a penetrating wound and a foreign body of the cornea. Material and methods. The article considers a real clinical case, starting from the moment of admission of the patient to the ophthalmology department and ending with the results achieved during the treatment. Results. The correct diagnostics and the correctly chosen method of treatment ensure the achievement of the best results. Conclusions. Previously, referral of patients with an eye injury for specialized care is important for achieving the best results during treatment. Keywords: eye injury, penetrating wound of the cornea, foreign body, optical coherence tomography (OCT)
A clinical case of a combination of congenital toxoplasmosis associated with HIV and cytomegalovirus infections
Authors:   Regional State Autonomous Healthcare Institution «City Ivano-Matreninskaya Children's Clinical Hospital», Irkutsk, Vaserchuck O.V. , Mikhelsone Y.V. ,   Regional State Autonomous Healthcare Institution «City Ivano-Matreninskaya Children's Clinical Hospital», Irkutsk, Livadarova Y.S. ,   Regional State Autonomous Healthcare Institution «City Ivano-Matreninskaya Children's Clinical Hospital», Irkutsk, Dorofeeva T.Y. ,   Regional State Autonomous Healthcare Institution «City Ivano-Matreninskaya Children's Clinical Hospital», Irkutsk, Osipova Y.G. ,   Regional State Autonomous Healthcare Institution «City Ivano-Matreninskaya Children's Clinical Hospital», Irkutsk
Published: April 2023

Toxoplasmosis is one of the problems of medicine, which has serious socio-economic significance. Congenital toxoplasmosis is manifested by severe fetal damage, its chronic course with lifelong preservation of the parasite in various organs and tissues, as well as the possibility of adverse perinatal outcomes. Purpose. To present a clinical case of congenital toxoplasmosis in a child: intrauterine chorioretinitis, meningoencephalitis in combination with HIV infection and current cytomegalovirus infection. Material and methods. A patient transferred from the Ust-Ilimsky maternity hospital to the city of Ivano-Matreninsky Children's Clinical Hospital in Irkutsk. Clinical data: in an HIV-infected mother, from 4 pregnancies, 4 births, a child was born at 39–40 weeks, 2930 gr. Results. Based on the conducted studies and examinations, the child was diagnosed with: Basic: Congenital toxoplasmosis: transferred intrauterine chorioretinitis, meningoencephalitis with the formation of calcifications of cerebral vessels, ventriculomegaly. Related: 1) HIV infection, stage 2 B, progression phase on ART, IC+2, moderate immunodeficiency; 2) Congenital cytomegalovirus infection; 3) UPU. Muscular DMZHP. Ltd. CH0; 4) Normochromic anemia of moderate severity. Conclusions. Congenital toxoplasmosis remains one of the serious problems and requires in-depth study. As a prevention of the development of congenital toxoplasmosis, it is necessary to diagnose infection with toxoplasmosis in women of fertile age during family planning. Keywords: congenital toxoplasmosis, chorioretinitis, meningoencephalitis, HIV infection, CMV infection
Clinical cases of severe postoperative course in children with uveal complications of laser coagulation in retinopathy of prematurity
Authors:   Russian children's Clinical Hospital of Pirogov Russian National Research Medical University, Kuznetsova Y.D. , Astasheva I.B. ,   Pirogov Russian National Research Medical University, Zvereva A.N. ,   Russian children's Clinical Hospital of Pirogov Russian National Research Medical University
Published: April 2023

The most likely complications of laser coagulation in the active stages of retinopathy of prematurityis the occurrence of a pronounced inflammatory process, which may requre surgical treatment. In most cases, a positive effect occurs after a single surgical intervention. Purpose. Analysis of three clinical cases of severe postoperative course in children with uveal complications of laser coagulation in retinopathy of prematurity. Discussion. In these cases, the severe course of the postoperative period was noted in somatically severe children, including those with severe bronchopulmonary dysplasia, with infectious diseases of various etiologies suffered in intrauterine and the early period of development, including after surgery. Conclusion. Children who have had uveitis after laser coagulation of the retina are subject to careful dynamic observation. It is necessary to conduct unscheduled examinations after infectious diseases. Keywords: retinopathy of prematurity, laser coagulation of retina, uveal complications, cataract