[Modern Approach and Successful Experience of Conservative Treatment of Infantile Hemangiomas with Non-Selective Beta-Blocker Propranolol].

The article deals with the actual problem of modern treatment of infant hemangiomas. The accumulated 10-year experience of using propranolol in 512 patients has shown its effectiveness and safety. The team of authors developed a protocol for managing patients with infantile hemangiomas of various localization at all stages of treatment. Special attention was paid to the cardiological aspect of patient monitoring using modern methods of instrumental diagnostics. Due to the clear application of the created protocol with the use of ultrasound control, in most cases, it was possible to achieve complete cure of this pathology, minimize incidence of undesirable effects and avoid the formation of relapses (rebound effect). The effectiveness of the developed algorithm of diagnosis and treatment is confirmed by both clinical results and the results of instrumental examinations.

[Ophthalmologic symptomatology in children with periventricular leucomalation].

Ophthalmologic symptoms were analyzed in 76 children with periventricular leucomalation (PL). Clinical or functional ophthalmic disorders were detected in 100% of patients. Changes in the optic nerve disc were diagnosed in 93.4% of patients. The syndrome of dilated excavation (SDE), i.e. dilation and cupping of the optic nerve disc combined in all cases with affection of postgenicular visual paths (of optic radiation and/or striatal cortex) verified by neuroradiology, was most frequently (80.3%) encountered in children with PL. Presumably, the progression of SDE is associated with transsynaptic retrograde degeneration conditioned by the hypoxic-ischemic affection of the CNS in the projection of postgenicular visual paths at pre- and perinatal stages. SDE is an important criterion in the diagnosis of lesions of postgenicular visual paths in babies.

[Neuro-ophthalmological and radiological signs of Aicardi syndrome]. / Neirooftal'mologicheskie i radiologicheskie proiavleniia sindroma Ecardi.

Described in the paper are the results of ophthalmologic, ultrasound and radiological examinations of 3 girls with the Aicardi syndrome. It was for the first time, that an expansion of the optic-nerve disk excavation was described in patients with the above syndrome; such expansion was conditioned by trans-synaptic neuron degeneration induced by lesions to optic radiation in view of prenatal of encephaloplastic processes. The changing brain white substance as projected by optic radiation was detected in all children by computer and magnetic resonance tomography. Besides, other anomalies of the optic nerve (bindweed syndrome, coloboma) and of the retina are elucidated. Finally, the pathogenesis and differential diagnostics of the Aicardi syndrome are under discussion.

[Isolated aplasia of the optic nerve]. / Izolirovannaia aplaziia zritel'nogo nerva.

The results of ophthalmologic examinations, including ophthalmoscopy, ultrasound Doppler-graphy as well as neuroradiological and electrophysiological investigations, of a 6-month boy with bilateral isolated aplasia of the optic nerve are described. The discussion comprises a literature survey dedicated to pathogenesis and diagnostics of optic-nerve aplasia in children.

[Tactics of treating children with Coat's disease]. / Taktika vedeniia detei s bolezn'iu Koatsa.

Fifty children with Coats disease, aged 2 months to 12 years (mean age 8.25 +/- 2.72 years), were observed. Four stages are distinguished in the disease course: initial, moderate, advanced, and terminal. Treatment including extensive retinal argon laser coagulation, cryotherapy, scleral bucking, and subretinal liquid draining was carried out in 32 children (33 eyes). Stable anatomic results were attained in 97% eyes. Visual acuity of at least 0.02 was retained in 87.9% children.

[Bullous form of X-linked congenital retinoschisis in infants]. / Bulleznaia forma X-stseplennogo vrozhdennogo retinoshizisa u detei rannego vozrasta.

Clinical manifestations and course of bullous X-linked congenital retinoschisis were studied in 10 infants aged 6-18 months. Visual function was evaluated by registration of electroretinogram and visual evoked potentials. The patients were followed up for 7.65 +/- 2.51 years. Giant retinal cysts were observed in 40% patients with X-linked retinoschisis aged under 3 years. Collapse (spontaneous or after laser coagulation of the retina) of retinal cysts with formation of demarcation pigmented lines was observed in 85% children. Twenty percent patients developed hemophthalmia which was completely resorbed within 4-12 months. At the age of 6-12 years visual acuity was 0.36 +/- 0.23. The prognosis of the condition is favorable, and therefore surgical treatment or laser coagulation are not recommended in infants with bullous retinoschisis, on condition that no negative changes in the disease course are observed.

[Delayed visual maturing in infants: differential diagnosis and treatment strategy]. / Zaderzhka zritel'nogo sozrevaniia u detei rannego vozrasta: differentsial'naia diagnostika i taktika vedeniia.

Results of long observations of 7 infants with delayed visual maturing, diagnosed at the age of 2-4 months by ophthalmological, electrophysiological, radiological methods and registration of electroretinogram (ERG) and visual evoked potentials (VEP), are analyzed. Delay of visual maturing is characterized by disorders of behavioral visual reactions in neonates with emmetropia, absence of ocular disease and oculomotor system, normal ERG and VEP in response to a light flash or 14-110' patterns, and absence of changes in the postgenicular tract detected by radiological examination. Diagnostic criteria of delayed visual maturing and symptoms important for differential diagnosis are defined.

[Anomalies of optic nerve excavation: the clinical manifestations and differential diagnosis]. / Anomalii ékskavatsii zritel'nogo nerva: klinicheskie proiavleniia i differentsial'naia diagnostika.

Clinical features, electrophysiological characteristics, neuroradiological symptoms and associations with systemic malformations have been studied in 76 children with abnormalities of the optic nerve excavation: the morning glory syndrome, optic nerve coloboma, and congenital peripapillary staphyloma. Based on the results, the criteria are determined for the differential diagnosis of these optic nerve abnormalities and the hypothesis on their different embryogenesis is confirmed.

[Ischemic lesions of the retina in a child with neurofibromatosis 1]. / Ishemicheskoe porazhenie setchatki u rebenka s neirofibromatozom 1-go tipa.

A rare case is described: unilateral diffuse retinal ischemia in a 3-year-old girl with type I neurofibromatosis. Besides retinal involvement, the child developed melanocytic iridial hamartomas in the ipsilateral eye and skin disorders presenting as "milk-and-coffee" spots and freckles in the armpits. Differential diagnosis and pathogenesis of retinal ischemia in neurofibromatosis are discussed.

[Remote results of surgical treatment rhegmatogenous retinal detachment in children]. / Otdalennye rezul'taty khirurgicheskogo lecheniia regmatogennoí otsloíki setchatki u deteí.

The results of surgical treatment of 53 children (55 eyes) with rhegmatogenous detachment of the retina complicated with proliferative vitreoretinopathy (PVR) are assessed. The patients were followed up for 10 months to 6 years. Complete adhesion of the retina after surgery was attained in 85.5% and improvement of vision acuity in 89.4% of patients. Postoperative complications occurred in 25.5%, but in only 10.9% of children they eventuated in an unfavorable outcome of surgery or a relapse of retinal detachment. The disease recurred in 19% of children in the course of follow-up. The efficacy of surgical treatment of detachment of the retina depends on the origin of the disease and severity of preoperative PVR.

[Visual evoked potentials in infants in health and hypoplasia of the optic nerve]. / Zritel'nye vyzvannye potentsialy u detei rannego vozrasta v norme i pri gipoplazii zritel'nogo nerva.

Visual evoked potentials (VEP) in response to chess field reversion were studied in 29 infants aged from 6 weeks to 1.5 years with optic nerve hypoplasia and in healthy age-matched controls. Analysis of VEP in healthy children showed that the interval between weeks 6-9 and 16-20 of life was the period of their most rapid maturation, this making this period in the development of the optic system of man particularly significant. Three types of VEP disorders were detected in patients with optic nerve hypoplasia; these types correlate with the size of the optic disk and behavioral reactions of a child. Together with the clinical data, VEP may be used for assessing the function of the optic system of children with optic nerve hypoplasia and for early diagnosis of this disease.

[Changes in contrast sensitivity in children with optic neuritis]. / Izmemneniia kontrastnoi chuvstvitelnosti pri nevritakh zritelnogo nerva u detei.

Changes of spatial contrast sensitivity (SCS) were studied in children with optic neuritis in the acute, convalescent, and remote periods of disease. A selective reduction of SCS of involved and intact eyes in the high frequency band was revealed, indicating the predominant involvement of the parvocellular subsystem of vision in optic neuritis. A correlation of SCS disorders with abnormalities of visual evoked potentials was revealed. The detected regularities indicate shifts on the part of the retrochiasmal structures in patients with optic neuritis, this being confirmed by studies making use of computer-aided tomography and magnetic imaging.

[Electrophysiological and neuroradiological methods in the diagnosis and prognostication of functional outcome in young children with lesions of the visual tract]. / Elektrofiziologicheskie i neiroradiologicheskie metody v diagnostike i prognozirovanii funktsional'nykh iskhodov u detei rannego vozrasta s porazheniem zritel'nykh putei.

The authors analyze the data of computer-aided tomography, neurosonography, and visual evoked potentials to chess pattern reversal in 14 infants aged 6 to 11 months with partial atrophy of the optic nerve and/or visual cortex involvement before and in various periods after transcutaneous electric stimulation combined with neurotrophic drug therapy. The advantages of comprehensive examinations in neuroophthalmological diagnosis in infants are shown, as is the possibility of using electrophysiological and neuroradiological methods for prediction of functional outcomes in the said patient population.

[Electrophysiological methods in assessing the risk for the development of multiple sclerosis in adolescents with monosymptomatic optic neuritis]. / Elektrofiziologicheskie metody v otsenke riska razvitiia rasseiannogo skleroza u podrostkov s monosimptomnym opticheskim nevritom.

Pattern electroretinograms and visual evoked potentials (VEP) were investigated in response to reversal checker-board patterns with different sizes of checks in 13 adolescents with monosymptomatic optic neuritis in acute period and in the course of convalescence 1-2 and 12-36 months after the disease onset. All the children underwent computer tomography of the orbit and brain. The results allowed identification of high and low multiple sclerosis risk groups. The high risk can be proved by a progressive increase of VEP latency 1-2 months after the disease onset and its significant advance in later period of optic neuritis. Normal VEP latency in late optic neuritis shows a low degree of its development.

[Visual evoked potentials in chessboard pattern reversion in children with optic neuritis]. / Zritel'nye vyzvannye potentsialy na reversiiu shakhmatnykh polei u detei s opticheskimi nevritami.

Visual evoked potentials (VEP) to chess pattern reversion were studied in 17 children with optic neurites during the acute stage and in the course of convalescence 1-2 months and 1-3 years after the disease onset. Coarse VEP changes were detected in the patients during the acute stage of optic neuritis. A positive time course of VEP was followed up in late periods after the acute attack of the disease. Despite normalization of vision acuity, no complete restoration of VEP to small-cell chess patterns was seen. The findings evidence that studies of VEP to chess pattern reversion should be carried out to detect subclinical involvement of the optic nerve and to timely diagnose optic neuritis in children.

[Examination of the optic nerve state in children with orbital injuries]. / Issledovanie sostoianiia zritel'nogo nerva pri travmakh glaznitsy u detei.

The results of comprehensive examinations of 13 children with orbital injuries, in whom injuries to the optic nerve were diagnosed, are analyzed. Computer-aided tomography and examinations with visual evoked potentials helped detect the signs of optic nerve injuries in the first days after the injury even in cases without ophthalmoscopic changes. Grave disorders of the involved eye visual evoked potentials were detected, that evidenced organic changes of the third neurone, despite high vision acuity. Disordered visual evoked potentials of the intact eye as against age-specific norm were detected in 8 children.