Yury Perfilie Complex approach to treatment of myopia.ppt ... Perfilie_Complex... · tonsillitis exacerbation, infectious hepatitis cause a general weakening of conjunctive tissues

C l h t t t t f C l h t t t t f Complex approach to treatment of myopia

Complex approach to treatment of myopia

in school-age children with help of SCENAR therapy

in school-age children with help of SCENAR therapySCENAR therapySCENAR therapy

Yu.I. Perfilev, I.P. Shurigina,N.M.Galenkina

Yu.I. Perfilev, I.P. Shurigina,N.M.Galenkina

DEPARTMENT OF PEDIATRICS №4DEPARTMENT OF PEDIATRICS №4DEPARTMENT OF PEDIATRICS №4DEPARTMENT OF OCULAR DISEASES №2DEPARTMENT OF OCULAR DISEASES №2DEPARTMENT OF OCULAR DISEASES №2ROSTOV STATE MEDICAL UNIVERSITYROSTOV STATE MEDICAL UNIVERSITYROSTOV STATE MEDICAL UNIVERSITY

BackgroundRefraction abnormalities are the main cause of eye disorders in schoolchildren today. The prevalence of myopia among school aged prevalence of myopia among school-aged children is 12 – 35%. Degenerative myopia ranks second among the g y p gcauses of eye-related handicaps in young adults. Its development is provided by the following factorsfactors.

Genetic predispositionChildren of myopic parents are frequently myopic.

Genetic predisposition

Primary weakness of accommodationCauses compensatory lengthening of sclera.

L d t f l d b tl t i Thi b

Unbalanced, strained accommodation and convergence

Lead to false and subsequently true myopia. This can be promoted by disorders of the autonomic nervous system, which is actively involved in accommodation, since the

i i fipupil sphincter and Brucke's fibers are controlled by the parasympathetic part, and the dilator muscle of pupil and Ivanov’s fibers by the sympathetic part. y y p p

General health condition can contribute much to myopia d l t S h di h ti th iti h i

General health decline

development. Such diseases as rheumatism, arthritis, chronic tonsillitis exacerbation, infectious hepatitis cause a general weakening of conjunctive tissues in the whole body, i l di th l S h l t d dil including the eye sclera. Such sclera extends readily, causing myopia progression.

Unfavorable environmentUnfavorable environmentProfessional training, involving too long time in front of video monitors too close to the eyes. When the body d l t i t l t d t i d l

Unfavorable environmentUnfavorable environment

development is not completed yet, myopia develops easily and its progression becomes persistent.

Periorbital ZoneE l d f b i Midpoint of each

eyebrow (VT6)External edge of an eyebrow, in the recess that corresponds to the lateral edge of the maxillary process of frontal bone (TR23)

Internal point of eyebrow (V2)

p ( 23)

0.5 cm outwards from the tail of the eye,

d t th tcorresponds to the outer edge of eye orbit (VB1)

0.3 cm inwards from the

Center of the lower eyelid (Е1)

1 cm downwards from the nasal edge of the eye (V1)

1 cm downwards from the lower eyelid, corresponds to the infraorbital foramen (Е2)

Collar Zone D-0

Collar Zone D-1

It is recommended to useparavertebral pawns.

Frequency Frequency Frequency ––– 60 Hz.60 Hz.60 Hz.ModeModeMode SDMSDMSDMModeModeMode––– SDM.SDM.SDM.Stimulation level Stimulation level Stimulation level ––– comfortable.comfortable.comfortable.Stimulation technique Stimulation technique Stimulation technique labilelabilelabileStimulation technique Stimulation technique Stimulation technique ––– labile.labile.labile.StumulationStumulationStumulation time time time ––– 333---5 min.5 min.5 min.

Treating with the ophthalmologic electrodeFor CHANS-SCENAR devicesFrequency 60 HzFrequency 60 HzModulation АМ 3:1Time 3 minSti l ti t h i St bilStimulation technique Stabile

For SCENAR-NT devicesFrequency FMModulation АМ 3:1Int - 3 Gap-40Int. 3 Gap 40Time 3 minStimulation technique stabilestabilestabile---labile,labile,labile,

DO NOT FORGET to set the minimum stimulation strength before placing the electrode on the skin.DO NOT FORGET to set the minimum stimulation strength before placing the electrode on the skin.DO NOT FORGET to set the minimum stimulation strength before placing the electrode on the skin.

In implementation (+) of the action, both local reflex mechanisms and general response of the body to the mechanisms and general response of the body to the stimulation are involved.

Local effects of pulse current manifest themselves as activated blood microcirculation and improved tissue trophism not only locally in the zone of influence but also trophism not only locally in the zone of influence but also in the eyeball (as it is the organ corresponding with this skin area) on the principle of dermatovisceral reflex.

Tonographic data proved normalization and/or prevention of microcirculatory-circulatory hypoxia in p y y ypnearsighted children.

Electric pulse stimulation with SCENAR was delivered once daily for 10 daysdaily for 10 days.

SCENAR-therapy was given at the Eye Health Care Office

Improvement in microcirculation makes a

and Eye Department of the District Children’s Hospital.

Improvement in microcirculation makes a morphofunctional basis for antihypoxic and anti-edema action, stimulation of metabolic and redox processes as

ll fl l i ff t f th th dwell as reflex-relaxing effect of the method.

Stimulation was applied on peripheral zones that have Stimulation was applied on peripheral zones that have biologically active points of the Chinese meridians associated with the functional state of the

d ti t f th d ti accommodative apparatus of the eye and retina electrogenesis.

MethodsMethodsIdentification of a concomitant somatic pathologyIdentification of a concomitant somatic pathology

Identification of burdened family backgroundIdentification of burdened family background

VisometryVisometry

RefractometryRefractometryyy

Accommodation indices (accommodation reserve)Accommodation indices (accommodation reserve)

Ophthalmoscopy (examination of the back part(fundus) of the eye)Ophthalmoscopy (examination of the back part(fundus) of the eye)

Neurophysiological measurements (electrophysiological study)Neurophysiological measurements (electrophysiological study)

Echobiometry (measuring the shape of the eyeball)Echobiometry (measuring the shape of the eyeball)

hild d thild d t

Clinical Profile of PatientsClinical Profile of Patients65 65 children aged 7 to 1565 65 children aged 7 to 15

Treatment was given at the Eye Health Care Office and Eye Department of the District Children’s Hospital.Treatment was given at the Eye Health Care Office and Eye Department of the District Children’s Hospital.

Clinical forms of eye pathology in the groups under testSpasm ofSpasm of

Eye Department of the District Children s Hospital.Eye Department of the District Children s Hospital.

Spasm ofaccommodation(pseudomyopia)

Spasm ofaccommodation(pseudomyopia) Mild and moderate

myopiaMild and moderate

myopia

24.6% 32.3%

myopiamyopia

15.4%15.4% 13.8%13.8%13.8%13.8%

Myopic astigmatismMyopic astigmatism Severe myopiaSevere myopiaEyestrain syndrome

Changes in visual acuity without corrective lenses

Group I -conventional management

100%

Group II –monotherapy with SCENAR

9540%

60%

80% Group III –multiple treatment + SCENAR-

therapy80%

100%

100%50%

20%

40%

9340%

60%

9660%

80%

0%Before

70%

20%

Before

4

96

20%

40%Low visual acuity (<0.1-0.3)Comfortable visual acuity (0.4-0.6)High visual acuity(0.7 and higher)

40%Before



100%


95

63

40%

60%


therapy80%

100%

100%5 7

30

0%

20%

40%

93

60

40%

60%

96

20

60%

80%

0%Before After

7 5

35

0%

20%

Before After

4

96

10

70

20%


4 100%Before After



100%


95

6385

40%

60%


therapy80%

100%

100%5 7

30

510

0%

20%

40%

93

60 70

40%

60%

96

20 22

60%

80%

0%Before After 12 months later

.

7 5

35

3

27

0%

20%

Before After 12 months later

4

96

10

70

8

70

20%


later

4 10 80%Before After 12 months

later

Changes of Neurophysiological Indices

Retinal Electrosensitivity

Group I Group II Group III

80%

100%

90 88 91

40%

60%

10 12 90%

20%

before beforebefore

> 70 µA≤ 70 µA (normal)




503080%

100%

90 88

70

91 10040%

60%

10

50

12

70

90%

20%

before beforebeforeafter after after





5030

5080%

100%

90 95 88

70

91 100 10040%

60% 12

10

50

5 12

7050

90%

20% months

12later 12 months

laterbefore beforebeforeafter after after

12 months

later


CHANGE OF ACCOMMODATION RESERVE


Accommodation Reserve:no reserve (0 – 0.25 dioptres)low reserve (up to 1.5 dioptres)normal reserve (3.0 dioptres and higher) 75%75% 65%65% 70%70%higher)

Before treatment

75%75%

25%

65%65%

35%

70%70%

30%




Before treatment

75%75%

25%

65%65%

35%

70%70%

30%

Group I Group II Group IIIIII

20%20%

70%10%5%5% 80%

15% 0,5%0,5%34,5%

65%After treatment

65%




Before treatment

75%75%

25%

65%65%

35%

70%70%

30%

Group I Group II Group IIIIII

20%20%

70%10%5%5% 80%

15% 0,5%0,5%34,5%

65%After treatment

65%


12 months later

III

5%5%50%50%

45%45%10%15% 75%

60%

39,5%0,5%

45%45% 60%

Myopia progression after Myopia progression after 12 12 monthsmonths

95%95%100

70% 75%80

90Group IGroup II

60

70Group IIGroup III

40

50

30%30%25%

20

30

5%

0

10

20

0stabilization progression

Long-term effects of SCENAR-therapy (12 th l t )

Long-term effects of SCENAR-therapy (12 th l t )(12 months later)(12 months later)

Beneficial action of SCENAR in nearsighted children:Beneficial action of SCENAR in nearsighted children:

-- In 78% children their vision acuity remained in the visual

comfort limits

-- In 78% children their vision acuity remained in the visual

comfort limits

-- Neurophysiological indices became normal in 100% -- Neurophysiological indices became normal in 100%

casescases

-- Functional state of the accommodative

apparatus became normal in 60%

-- Functional state of the accommodative

apparatus became normal in 60%pppp

CONCLUSIONCONCLUSIONCONCLUSIONCONCLUSION

High therapeutic effect of SCENAR therapy technique, if pathology of visual analyzer is High therapeutic effect of SCENAR therapy technique, if pathology of visual analyzer is q , p gy ythere, makes the method quite perspective

for treatment of myopia among children

q , p gy ythere, makes the method quite perspective

for treatment of myopia among childrenfor treatment of myopia among children

Including SCENAR therapy in the

for treatment of myopia among children

Including SCENAR therapy in the Including SCENAR-therapy in the conventional management prevents myopia

Including SCENAR-therapy in the conventional management prevents myopia in 80% cases and stops myopia progression in

70%. in 80% cases and stops myopia progression in

70%.

Thank you!Thank you!Thank you!Thank you!

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Yury Perfilie Complex approach to treatment of myopia.ppt ... Perfilie_Complex... · tonsillitis exacerbation, infectious hepatitis cause a general weakening of conjunctive tissues