Trifocal intraocular lens implantation to treat visual demands in Mongolian patients / Монголын Анагаах Ухаан

Introduction@#Intraocular lens (IOL) implants are monofocal and trifocal lenses which helps to clear up the vision after cataract surgery.@*Goal@#In this work, we aimed to compare the monofocal and trifocal IOL implantation during phacoemulsification surgery.@*Materials and Methods@#This study was conducted on 133 participants. Females comprised n=81, mean n=52 into equal groups. Preoperative and Postoperative cataract surgery UCVA and BCVA were measured and compared during the after 1 day, week 1, 2 weeks and month1. @*Statistical analysis@#The results of the study were processed using the SPSS 25.0 program after coding the data and checking for typographical errors. The normality of the data distribution was tested by inspecting a histogram. Categorical variables were compared using the chi-square test or Fisher's test. Statistical significance was determined at a p-value lower than 0.05@*Ethical statement@#The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (No.2021/05/21). All patients provided written informed consent before participating in this study.@*Results@#The mean preoperative UCVA was 1.09±0.45D in monofocal IOL group, 0.99±0.49D in trifocal IOL group. At the first week: The mean postoperative UCVA at one week was 0.34±0.29D and 0.27±0.17D, in each group respectively. The mean postoperative BCVA in the first week was 0.28±0.27D and 0.20±0.15D in each group respectively. The mean postoperative UCVA at 1 month was 0.27±0.24D and 0.15±0.16D in each group, while BCVA was 0.26±24.94D and 0.06±0.63D.There was a highly significant statistical difference between the result of UCVA preoperative and the results of UCVA at the early and last postoperative follow up. @*Conclusion@#From our results, the best corrected visual acuity and was better for Trifocal group than Monofocal group. It is evident that post-operative near UCVA and BCVA was statistically significant at monofocal and trifocal groups.

The comparison of retinal findings in end stage of CKD and in diabetic renal failure / Шинэ санаа Шинэ нээлт

Background@#Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy.@*Purpose@#To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure@*Methods@#Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination.@*Results@#Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole.@*Conclusion@#Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Findings of the assessment on social and the environmental accessibility for people with vision and hearing impairment / Шинэ санаа Шинэ нээлт

Background@#According to the WHO, WB estimation, there are over 1 billion people living with some form of disability in the world.² Out of which, 284 million people have vision impairment, 360 million people have hearing and speech impairment, ten percent of them living in developing countries.³ According to the National Statistical Office’s 2018 data there are 105,730 people with disabilities in the country which is 3.2% of the total population.⁴ In Mongolia, 28% of the disabled population in the working age are employed while 43% of the population aged 6-18 are illiterate. People with vision, hearing and intellectual disabilities have the same right to access health, education, employment, social welfare and protection services as others, but due to the lack of access to facilities and public transport, they cannot fully access social services. Also, the legal framework that provides equal opportunities for social contacts is not enough. There is virtually no comprehensive study on access of social service and environmental accessibility for the disabled people in the country. Therefore, there is a need to study in detail of social services and environmental accessibility of the people with visual and hearing impairment and adapt their demands into policy and develop policy recommendations and to further improve legal regulations.@*Purpose@#Main objective of the study is to assess social service delivery and environmental accessability of the people with visual and hearing impairment@*Methods@#The direct-observation, household based survey and document review, methods have been used for this study. Direct observation method has been applied for 100 public constructions. Total of 100 disabled people, out of 50 people with visual impairment and 50 people with hearing impairment has been covered for the public transportation accessibility assessment questionnaire survey. Information and communication accessibility studies carried out among 100 organizational websites and 31 broadcasting internet television including Univision and Sky media. </br> Household survey covered 148 people with visual and hearing impairments to assess social service accessibility.@*Results@#The public construction’s environmental accessibility for the people with vision impairment was assessed at 48.8 percent: 36.8% for the people with poor vision impairment and very bad for blind people at only 16.5%. The public transportation accessibility assessed as not accessible (3.43 odds) for people with vision impairment and as moderate accepable for blind people (2.87 odds). Information and communication accessibility through website assessed at 25% for people with vision impairment which shows not sufficiently accessible for blind people (32%). Total accessibility of information regarding to the organizational website assessed at 34.8% which shows moderately accessible. Services of the Univision, Sky media internet TV (IPTV) wasn’t accessible for people with vision impairment. Regarding to the people with hearing impairment, public construction environmental accessibility assessed at 31.7%, 48.5% for people with moderate hearing impairment which is average accessibility and 21% people with severe hearing problem. The public transport accessibility assessed in high discrepancy (3.51 odds ratio) which means there is an in-sufficient access. Information and communication accessibility for people with hearing impairment assessed at 5% which shows very bad accessibility. </br> Health service coverage is 64% for the people with vision impairment while 36% for the people of hearing impairment. Education service coverage for vision impairment people is 36% and 18% to people with hearing impairment. Regarding to the accessibility to social service, the coverage is 33% for people with vision impairment and 31% for the people with hearing impairment. Employment rate among people with vision disability resulted in 19% and 24 % for the people with hearing imapirment.@*Conclusion@#The public constructions accessibility for people with vision and hearing impairment (37.7%), public transport accessibility (2.90 odds ratio), information accessibility (34.8%) assessed at “moderately accessible”. Assessment result of below 50% considered as “insufficient” for education service -27%, employment service-21.5%, social welfare services -32%. There is a need for special laws and regulations concerning to social services and environment accessibility.

Clinical features of ophthalmology in thyroid disease / Шинэ санаа Шинэ нээлт

Background@#TED (thyroid eye disease) is an inflammatory disease of the orbit caused by autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the most common clinical signs of TED in Mongolians and define whether there is a correlation with the levels of thyroid autoantibodies.@*Methods@#The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy. The clinical features of TED were identified and evaluated by activity score (CAS) and severity of GO using the European Group of Graves’ Orbitopathy (EUGOGO).@*Results@#The mean age of TED patients was 42.6±11.2, which was younger than GD patients (P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD (P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%), diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18 mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU / ml, which was 2.7 times higher than the mean in patients with GD.@*Conclusions@#Eyelid retraction and exophthalmos are the most common clinical signs of TED. Early diagnosis of these features can prevent complications of the disease. Determining serum TSI levels will help in the treatment and monitoring of TED.

Glaucoma in Mongolia. A population-based survey in Hövsgöl province, northern Mongolia.

OBJECTIVES: To determine the prevalence of glaucoma and suspect glaucoma, and to classify the cases detected according to mechanism. DESIGN: A population-based prevalence study. SETTING: Rural and urban locations in Hövsgöl province, northern Mongolia. PARTICIPANTS: Nine hundred forty-two (94.2%) of 1000 individuals 40 years of age and older were examined. MAIN OUTCOME MEASURE: Primary angle-closure glaucoma was diagnosed in subjects with previous acute or intermittent symptoms of angle closure and in individuals with an occludable angle and an intraocular pressure greater than 19 mm Hg or a glaucomatous visual field. RESULTS: The prevalence of manifest primary angle-closure glaucoma was 1.4% (14 subjects). The prevalence of gonioscopically occludable angles was 6.4% (64 subjects, including those with glaucoma). Primary open-angle glaucoma was diagnosed in 5 subjects (prevalence, 0.5%). As all these subjects were older than 60 years, the prevalence became 2.1% for this age group. Three cases (prevalence, 0.3%) of secondary open-angle glaucoma were detected. No cases of secondary angle-closure glaucoma were diagnosed. The prevalence of blindness was 1.2% (12 subjects), and primary glaucoma accounted for one third of these cases (4 subjects). CONCLUSIONS: We confirmed glaucoma as a major public health problem in northern Mongolia. Primary angle-closure glaucoma is more prevalent than primary open-angle glaucoma, supporting clinic-based data from other east Asian countries. Among the subjects examined, 97 (9.7%) had either manifest, latent, or suspect glaucoma. Neighboring populations may be similarly affected owing to a shared genetic heritage.

Anterior chamber depth measurement as a screening tool for primary angle-closure glaucoma in an East Asian population.

OBJECTIVE: To evaluate anterior chamber depth measurement as a method of screening for primary angle-closure glaucoma in an East Asian population. DESIGN: Two-phase, cross-sectional, community-based study. SETTING: Rural and urban locations in the Hovsgol and Omnogobi provinces, Mongolia. PARTICIPANTS: Nine hundred forty-two (94.2%) of 1000 individuals in Hovsgol(1995) and 775 (96.9%) of 1000 individuals in Omnogobi (1997) aged 40 years or older were examined. MAIN OUTCOME MEASURES: Anterior chamber depth was measured by optical pachymetry, slitlamp-mounted A-mode ultrasound, and handheld ultrasound. Gonioscopy was used to detect occludable angles, defined as one in which the trabecular meshwork was visible for less than 90 degrees of angle circumference. Primary open-angle glaucoma was diagnosed in subjects with an occludable angle and glaucomatous optic neuropathy with visual morbidity. The area under the curve in a receiver operating characteristic plot was used to compare test performance. RESULTS: Optical pachymetry outperformed the slitlamp-mounted ultrasound method of anterior chamber depth measurement (area under the curve, 0.93 and 0.90, respectively; z test, P = .001). Handheld ultrasound (area under the curve, 0.86) was inferior to optical measurement (z test, P = .001) but did not differ significantly from slitlamp ultrasound (z test, P = .06). The optical method gave sensitivity of 85% and specificity of 84% at a screening cutoff of less than 2.22 mm for detecting occludable angles. CONCLUSIONS: Measurement of axial anterior chamber depth can detect occludable angles in this Asian population and therefore may have a role in population screening for primary angle-closure glaucoma.

Anterior chamber depth in Mongolians: variation with age, sex, and method of measurement.

PURPOSE: To document anterior chamber depth in a Mongolian population and quantify the variation in this parameter attributable to age, sex, and method of measurement. METHOD: Depth of the anterior chamber was measured by optical pachymetry in 1,242 subjects aged 10 to 87 years. Figures for "true" anterior chamber depth were calculated by subtracting central corneal thickness from the distance between the anterior corneal epithelium and anterior lens capsule. A-mode ultrasound was also used to measure the distance from anterior corneal epithelium to anterior lens capsule in 94% (942) of subjects aged 40 years and older. These ultrasound data were compared with measurements of the same distance obtained by optical pachymetry. RESULTS: Mean anterior chamber depth in women was more shallow than in men of all ages (ANOVA, P < .0001), although this difference varied according to age. Mean anterior chamber depth decreased with age and was most accurately represented by a cubic function of age. This change was maximal between the ages of 30 and 60 years and equaled 0.15 mm per decade in men and 0.21 mm per decade in women. Mean depth of the anterior chamber measured by ultrasound was significantly less than the equivalent optical measurement (difference of 0.14 mm in right eyes, P < .001). CONCLUSIONS: Mean anterior chamber depth in Mongolians decreases with age and is more shallow in women than in men. Ultrasound and optical methods of anterior chamber depth measurement yield significantly different results and are therefore not directly comparable.

YAG laser iridotomy treatment for primary angle closure in east Asian eyes.

AIM: To assess the efficacy of Nd:YAG laser iridotomy as initial treatment for primary angle closure in a community setting in rural Mongolia. METHODS: Subjects with occludable drainage angles in two glaucoma prevalence surveys in Mongolia (carried out in 1995 and 1997) were treated with YAG laser iridotomy at the time of diagnosis. These patients were re-examined in 1998. Patency of iridotomy, intraocular pressure (IOP), visual acuity, and gonioscopic findings were recorded. Iridotomy was classified unsuccessful in eyes where further surgical intervention was required or in which there was a loss of visual acuity to <3/60 from glaucomatous optic neuropathy. RESULTS: 164 eyes of 98 subjects were examined. Patent peripheral iridotomies were found in 98.1% (157/160) of eyes that had not undergone surgery. Median angle width increased by two Shaffer grades following iridotomy. Iridotomy alone failed in 3% eyes with narrow drainage angles and either peripheral anterior synechiae or raised IOP, but normal optic discs and visual fields. However, in eyes with established glaucomatous optic neuropathy at diagnosis iridotomy failed in 47%. None of the eyes with occludable angles that were normal in all other respects, and underwent iridotomy, developed glaucomatous optic neuropathy or symptomatic angle closure within the follow up period. CONCLUSIONS: Nd: YAG laser iridotomy is effective in widening the drainage angle and reducing elevated IOP in east Asian people with primary angle closure. This suggests that pupil block is a significant mechanism causing closure of the angle in this population. Once glaucomatous optic neuropathy associated with synechial angle closure has occurred, iridotomy alone is less effective at controlling IOP.

Screening for primary angle closure in Mongolia: a randomised controlled trial to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma in an east Asian population.

AIM: To describe the methods used and initial results of a prospective study designed to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma (PACG) in Mongolia. METHODS: A total of 4725 individuals aged 50 years and above were recruited to the study and randomised to intervention or control groups. All subjects had non-mydriatic optic disc examination. The intervention arm had measurement of anterior chamber depth (ACD) by A-scan ultrasound and intraocular pressure (IOP) with Tonopen. Gonioscopy was performed on test positive cases (ACD <2.53 mm or IOP >or=24 mm Hg either eye). Those with occludable angles were offered laser iridotomy. Primary outcome will be incidence of PACG at 5 year follow up. RESULTS: Glaucoma was diagnosed in 128 (2.7%) subjects. Of the remaining 4597, 2293 were randomised to intervention. Intervention as allocated was received by 2280 (99.4%) individuals. 160 (23.4%) of 685 test positive cases had occludable angles, of which 156 were treated with iridotomy. CONCLUSIONS: This trial is a further step in determining whether screening and prophylactic treatment for primary angle closure in east Asian populations will reduce the incidence of glaucoma.

Detection of gonioscopically occludable angles and primary angle closure glaucoma by estimation of limbal chamber depth in Asians: modified grading scheme.

AIM: To evaluate the performance of limbal chamber depth estimation as a means of detecting occludable drainage angles and primary angle closure, with or without glaucoma, in an east Asian population, and determine whether an augmented grading scheme would enhance test performance. METHOD: A two phase, cross sectional, community based study was conducted on rural and urban areas of Hövsgöl and Omnögobi provinces, Mongolia. 1800 subjects aged 40 to 93 years were selected and 1717 (95%) of these were examined. Depth of the anterior chamber at the temporal limbus was graded as a percentage fraction of peripheral corneal thickness. An "occludable" angle was one in which the trabecular meshwork was seen in less than 90 degrees of the angle circumference by gonioscopy. Primary angle closure (PAC) was diagnosed in subjects with an occludable angle and either raised pressure or peripheral anterior synechiae. PAC with glaucoma (PACG) was diagnosed in cases with an occludable angle combined with glaucomatous optic neuropathy and consistent visual morbidity. RESULTS: Occludable angles were identified in 140 subjects, 28 of these had PACG. The 15% grade (equivalent to the traditional "grade 1") yielded sensitivity and specificity of 84% and 86% respectively for the detection of occludable angles. The 5% grade gave sensitivity of 91% and specificity of 93% for the detection of PACG. The interobserver agreement for this augmented grading scheme was good (weighted kappa 0.76). CONCLUSIONS: The traditional limbal chamber depth grading scheme offers good performance for detecting occludable drainage angles in this population. The augmented scheme gives enhanced performance in detection of established PACG. The augmented scheme has potential for good interobserver agreement.

Aetiology of congenital pediatric cataract in Mongolia / Шинэ санаа Шинэ нээлт

Aim@#The aim was to determine etiology and clinical presentation of pediatric cataract during 1 year period@*Methods@#NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21 provinces and UB. Database contains cases during 1 year period. We have recorded the following data from the medical histories of these patients: family history, current age, age at diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and other investigations which were performed as clinically indicated. We have operated 80 children in total during 1 year period, however the study included 68 patients (91), eyes excluding 12 patients.@*Results@#Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25% were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to penetrating trauma.@*Conclusions@#Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3 of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up associating congenital/infantile cataract with Down syndrome weren’t rare.

VEGF-A and ARMS2 gene polymorphism on AMD susceptibility / Шинэ санаа Шинэ нээлт

Background@#Age-related macular degeneration (AMD) is an eye condition, that occurs people aged above 50, leads to gradual loss of the vision because of a damage in the macula, which is located in the center of the retina. Several polymorphisms in different genes have been proposed as factors that increase the disease susceptibility. Therefore, we investigated the association between rs833061 polymorphism of VEGF-A gene and rs10490924 polymorphism of ARMS2 gene and AMD in order to analyze with other similar studies by meta analysis.@*Purpose@#To investigate the polymorphisms of VEGF-A gene and ARMS2 gene on AMD susceptibility@*Methods@#is case-control study was conducted on 74 AMD patients and 32 unaffected age-and gender-matched control individuals. Genomic DNA was extracted from the peripheral venous blood. The single nucleotide polymorphisms were identified by restriction fragment length polymorphism (RFLP) method and results confirmed by gel electrophoresis. The REVIEW MANAGER 5.2 software and MetaXL was used for meta-analysis@*Results@#We did not find statistically significant differences in С allele and СС genotype frequency of rs833061 polymorphism of VEGF-A gene between patients and controls. However, analysis of rs10490924 polymorphism of ARMS2 gene shows that T allele (OR=2.72, 95% CI, 1.47 – 5.02, p=0.001), TT genotype (OR=4.54, 95% CI, 1.49 – 13.87,p=0.019) were significantly associated with AMD risk. Haplotype analysis of these SNPs showed that C+T haplotype was statistically significantly different (OR=5.23, 95% CI, 1.76-15.54, p=0.002) between patients and controls.@*Conclusion@#As shown by results, rs10490924 polymorphism of ARMS2 gene show that T allele, TT genotype and C+T haplotype were significantly associated with AMD risk In meta-analysis, T allele of rs10490924 polymorphism of ARMS2 gene was significantly associated with AMD risk in all ethnicity that include Asian and Caucasian. However, T allele prevalence was higher in Asians.

Hemangioma cases and treatment / Шинэ санаа Шинэ нээлт

Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.

Results of treatment for sight-threatening diabetic macular edema / Шинэ санаа Шинэ нээлт

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.

Survey about correlation between senile cataracts types and some constituents of biochemistry / Шинэ санаа Шинэ нээлт

Cataract is the leading cause of low vision and blindness in the world. Most cataracts are related to aging because the life expectancy of population becomes increased in the world.However, the research ofthe types of cataracts has been studied in Mongolia, it is not investigating correlation between in the types of cataracts and the result of biochemistry, therefore it was the background of our research. To determine the correlation among the mongolians aged 50 and older for compare some biochemical results of blood and types of the senile cataract.Total 80 patients with cataract and aged over 50 were case-based selected for the study from November 2010 to November 2011 at the Department of Ophthalmology ofFirstCentral Hospital of Mongolia. There had been collected according to the questionnaire of risks, and records of biochemical examination. Eye examinations had been performed lenses evaluated with the biomicroscope and determined the lens opacities rightly to Lens Opacities Classification Systems-III (LOCS III, the international standard classification). And we used SPSS 16.0, The mean age of all participants was 70 (±9.36) years and 56.2% were female, 43.8% males. The study shows that cataract types: nuclear was 48.8%, cortical 10%, posterior subcapsular (PSC) 41.2%. The hypertriglyceridemia (≥2.26 mmol/L) was associated with PSC (p = 0.025). There was no statistically significant association between blood glucose and cholesterol level and senile cataract. Nuclear cataract was the most common type of senile cataracts in Mongolia. It was same that hypertriglyceridemia was related to PSC developing in comparison of some studies, which conducted in some nations.

Some aspect of diagnosis and type of clinical management and risk factors of age-related macular degeneration / Шинэ санаа Шинэ нээлт

Age-related macular degeneration (AMD) is the leading cause of severe visual loss in people aged 50 years or older. It estimates that 25-35 million people lost vision due to AMD in the world. Rapid increase of aging population, 33.2 million people was affected by AMD in 1994and there is estimation the number will reach 80 million by 2050. Prevalence of disease is different in countries it relates due to aging population and the ratio is higher in developed countries. The risk factors of AMD; race, nationality, life style, cigarette smoking, alcoholconsumption, UV exposure, diet, vitamin or food supplements consumption, drugs and high blood pressure. This study was to evaluate risk factors in age related macular degeneration because cigarette smoking, alcohol consumption and high blood pressure are high among elder Mongolians. Introduction of Optical Coherent Tomography /OCT/ in ophthalmology enables us to early diagnose and prevention. It will be basic data for developing AMD prevention policy and improving methods of diagnosis and management.

Human fetal eyeball layers’ structure, differentiation and vascularization / Шинэ санаа Шинэ нээлт

Studying formation and development of fetal organ system, it has reliable information in medical theory as well as practical importance for the medical diagnosis, treatment and prevention in certain country. Introducing the modern advanced methods of fetal study in our country, it willbe possible to get the necessary information of prenatal organ development, formation and differentiation. Currently, the research works of eyeball development, topography, structures have not been accomplished yet in the Mongolian human fetuses. Therefore, the aim of thiswork was to make an evaluation of the development of the human eye during the fetal life. In our study, the 66 eyeballs of 33 human fetuses were examined.It was observed that the axial length, corneal diameter and equatorial diameter of the eye were increased simultaneously in the early fetal period. In the late period the axial length was increased slightly and equatorial diameter was increased rapidly. In the histological observation, the thickness of the eyeball layers were increased regularly from the early fetal period until the late fetal period. Thickness of the choroid and retina were increasing irregularly. Anti VEGFantibody was high distinguished detected in the choroid and retina in the early fetal period but it was middle distinguished detected in the late fetal period by immunohistochemistry.

Intravitreal bevacizumab and laser therapy in the management of diabetic macular edema / Шинэ санаа Шинэ нээлт

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 40 and 59 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significantpublic health issue. The Early Treatment Diabetic Retinopathy Study (ETDRS) showed the benefit of focal/grid laser for the management of DME, reducing the risk of moderate visual loss by approximately 50%, and since then,macular photocoagulation (MPC) has been the gold standard treatment. Vascular endothelial growth factor (VEGF) is an important mediator of blood-retinalbarrier breakdown, which leads to fluid leakage and the development of macular edema. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an optionthat must be considered for the treatment of DME. The aim of this study to evaluate intravitreal bevacizumab and modified Early Treatment Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) in patients with clinically significant macular edema (CSME). Methods: In a1-year, single-center, randomized controlled trial, 70 patients with center-involving CSME were randomized to receive either bevacizumab or MLT. Result: The baseline mean ETDRS BCVA was 58.3±8.6 (range 38–71) in the bevacizumab group and 56.6±7.3 (range 37–69) in the laser group. The mean ETDRS BCVA at one year was 63.2±12.5 (range 41–80) in the bevacizumab group and53.0±8.3 (range 35–74) in the laser group (p=0.0004). At one year, central macular thickness decreased from 405±121 μm (range 275–715 μm) at baseline to 247±141 μm (range 178±541 μm) in the bevacizumab group and in the laser group from 392±137 μm (range 284–741 μm) to 318±129 μm (range 165–615 μm) (p=0.05). Conclusioni: The study provides evidence to support the use of bevacizumab in patients with center involving CSME without advanced macular ischemia.

Outcome of laser surgery for mild myopia and myopic astigmatism / Шинэ санаа Шинэ нээлт

LASIK is the most popular treatment method for correction of the refractive errors of ophthalmology its development in 1990 and number of patients has continued to increase.The safety and efficacy of LASIK surgery have been reported several times by numerous researchers and doctors, but all studies have made abroad. This time we have summarized postoperative outcomes of LASIK surgery, which have performed in our country. Consequently 103 patients (206 eyes) who underwent LASIK surgery in “Bolor-Melmii” eye clinic between 2007 and 2011 were enrolled. The retrospective method of study was used to evaluate postoperative outcomes. Preoperative UCVA of 0.04-0.4 improved to 0.5-1.2(decimal) at 1 day after surgery and during 1 year after surgery revealed minimal but wasstable. Preoperative mean sphere equivalent of 2.2+/-0.72D improved at the 1 year by +/-0.5D in 161 eyes (78.15%), by +/-1.0D in 39 eyes (18.9%) and by +/-2.0D in 6 eyes (2.9%)after surgery. Mean sphere equivalent and astigmatism improved to -0.46 +/-0.4D and -0.43+/-0.34D respectively at 1 year after surgery. Improvement of the sphere equivalent and its stability during a year period of study proves that LASIK surgery is an effective with stable improvements and safe procedure for correcting myopia/myopic astigmatism. No severe complications occurred during and after surgery.

SCREENING THE NEWBORN FOR DYSPLASIA OF THE HIP / Шинэ санаа Шинэ нээлт

Developmental Dysplasia of the Hip (DDH) is a major health problem which can lead to lifelong handicapped condition of individuals if early diagnosis is missed. Cost for treatment, surgery and rehabilitation of these cases is much higher than that for prevention. According to Graf, hip ultrasound screening method is simple, reproducible, innocuous and can be performed by well- trained neonatologists. The purpose of this study is to determine prevalence and types of hip dysplasia by Graf standard screening method. A prospective study was carried out. Hip ultrasound screening using Graf method was performed by neonatologists at the Amgalan of maternity of the Capital city from January 2013 to March 2015.Totally 6154 neonates were eligible for the study and 50.9% of them were male, 93.27% term and 6.72% preterm, in 8.53% of babies, type IIa (physiological retardation of ossification)was found. Dysplasia or dislocation of hips (type III and IV) was found in 5 (0.08%) neonates. Babies diagnosed with type I on both hips were discharged. Type IIa cases were stopped being swaddled and reassessed after 4 weeks. Cases with type III and IV cases were all treated with abduction treatment or Tubinger. This study is an ongoing project. The implementation of the hip ultrasound screening according to Graf is feasible and can be performed by well-trained neonalogists in Amgalan of maternity of the Capital city.