YU.I.PERFILIEV, I.P.SHOURYGINA YU.YU.STAROVOITOV , M.K. SHOURYGINA

1. SCENAR-THERAPY OF MYOPIA IN SCHOOLCHILDREN WITH EXTRAOCULAR PATHOLOGY YU.I.PERFILIEV, I.P.SHOURYGINA YU.YU.STAROVOITOV, M.K. SHOURYGINA DEPARTMENT OF PEDIATRICS №4 DEPARTMENT OF OCULAR DISEASES №2 ROSTOV STATE MEDICAL UNIVERSITY

2. Background Different eye pathologies are one of the most widespread diseases among children and adults, with the prevalence from 29 to 57% In different regions of Russia the prevalence of myopia among children is 20-80.7%

3. Background Commonly myopia develops when the body is weaked as a result of a pathology in vertebrobasilar vessel bloodflow , ANS abnormality, as well as chronic infectious, vegetative and cardiac disease.

4. Background SCENAR-therapy is a brand new concept in the Rehabilitation Ophthalmology. It simultaneously influences compensatory-adaptive mechanisms of the vision system and general well-being.

5. Electric pulse stimulation with SCENAR was delivered once daily for 10 days. SCENAR-therapy was given at the Eye Health Care Office and Eye Department of the District Children’s Hospital. Improvement of microcirculation in orbital and vertebrobasilar systems makes a morphofunctional basis for antihypoxic action, stimulation of metabolic and redox processes in visual organ and brain, as well as reflex-relaxing effect of the physiotherapeutic method. Positive therapeutic effect is provided both by local reflex mechanisms and by general response of the body to the external stimulation.

6. Stimulation was applied on peripheral zones that have biologically active points of the Chinese meridians associated with the mechanisms that regulate adaptation of the visual system to longtime visual work. 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 in the eyeball (as it is the organ corresponding with this skin area) on the principle of dermatovisceral reflex. Dopplerographic data proved normalization and/or prevention of circulatory hypoxia in nearsighted children with complicated somatic pathology.

7. Collar Zone Periorbital Zone 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) 0.5 cm outwards from the tail of the eye, corresponds to the outer edge of eye orbit (VB1) 0.3 cm inwards from the nasal edge of the eye (V1) Center of the lower eyelid (Е1) 1 cm downwards from the lower eyelid, corresponds to the infraorbital foramen (Е2)

8. Research Methods Identification of a concomitant somatic pathology Identification of a burdened family background Measurement of the acuteness of form vision (distant and near) Refractometry Dopplerography (diagnostics of orbital bloodflow) Ophthalmoscopy (examination of the back part of the eyeball) Rheoencephalography (clinical method used to investigate the blood supply to the human brain) Echobiometrics (analysis of myopia progression)

9. 16% 68% 9,5% 11% 15% 75 children aged 7 to 16 Clinical Profile of Patients Treatment was given at the Eye Health Care Office and Eye Department of the District Children’s Hospital. Rate of somatic diseases among school-aged children with complicated myopia Neuro-circulatory dystonia Incorrect posture Nose conditions Other disorders Intestinal diseases

10. Low visual acuity (<0.1-0.3) Comfortable visual acuity (0.4-0.6) High visual acuity(0.7 and higher) Changes in visual acuity without corrective lenses Before treatment After treatment In a year Groups Group I - conventional management Group II – monotherapy with SCENAR Group III – multiple treatment + SCENAR-therapy

11. Orbital bloodflow Resistance index of orbital artery Before treatment After treatment In a year Group I – conventional therapy Group II – monotherapy with SCENAR Group III– multiple treatment + SCENAR-therapy norm above norm

12. Orbital bloodflow Mean bloodflow rate in orbital artery Before treatment After treatment In a year Groups Group I – conventional therapy Group II – monotherapy with SCENAR Group III– multiple treatment + SCENAR-therapy norm below norm

13. Cerebral hemodynamic Vertebral artery system Peripheral resistance index After treatment In a year Before treatment Group I – conventional therapy Group II – monotherapy with SCENAR Group III– multiple treatment + SCENAR-therapy norm above norm

14. Cerebral hemodynamic Vertebral artery system Rheographic index (RI) Before treatment After treatment In a year Group I – conventional therapy Group II – monotherapy with SCENAR Group III– multiple treatment + SCENAR-therapy norm below norm

15. Myopia progression after 12 months Group II Group III Group I 5% 70% 25% 30% 75% 95% Stabilisation Progression

16. Long-term effects (12 months later) of SCENAR-therapy SCENAR-therapy effectiveness in multiple rehabilitation ophthalmological treatment: 1) Improvedvision acuity to the visual comfort limits in 78% children 2) Restored orbital bloodflow indices in 100%children 3) Corrected cerebral hemodynamic indices in the vertevrobasilar system in 100%children 4) Stabilised myopia in 70%children

17. CONCLUSION Complementing multiple rehabilitation ophthalmological treatment of myopia in schoolchildren with extraocular pathology improves functional potential and adaptive mechanisms of the visual organ to the visual load.

18. Thank you!