1. YU.I.PERFILIEV, I.P.SHOURYGINA YU.YU.STAROVOITOV, M.K. SHOURYGINA YU.I.PERFILIEV, I.P.SHOURYGINA YU.YU.STAROVOITOV, M.K. SHOURYGINA SCENAR-THERAPY OF MYOPIA IN SCHOOLCHILDREN WITH EXTRAOCULAR PATHOLOGY DEPARTMENT OF PEDIATRICS №4 DEPARTMENT OF OCULAR DISEASES №2 ROSTOV STATE MEDICAL UNIVERSITY 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 In different regions of Russia the prevalence of myopia among children is 29 to 57% 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. 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. 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. 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 ZonePeriorbital Zone Midpoint of each eyebrow (VT6) 0.3 cm inwards from the nasal edge of the eye (V1) Internal point of eyebrow (V2) External edge of an eyebrow, in the recess that corresponds to the lateral edge of the maxillary process of frontal bone (TR23) 0.5 cm outwards from the tail of the eye, corresponds to the outer edge of eye orbit (VB1) Center of the lower eyelid (Е1) 1 cm downwards from the lower eyelid, corresponds to the infraorbital foramen (Е2)

8. Identification of a concomitant somatic pathology Research Methods Identification of a burdened family background Measurement of the acuteness of form vision (distant and near) Refractometry 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. Treatment was given at the Eye Health Care Office and Eye Department of the District Children’s Hospital. 75 children aged 7 to 16 Rate of somatic diseases among school-aged children with complicated myopia Clinical Profile of Patients 16% 9,5% 68% 11% 15% Intestinal diseases Other disorders Incorrect posture Neuro-circulatory dystonia Nose conditions

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

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

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

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

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

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

16. SCENAR-therapy effectiveness in multiple rehabilitation ophthalmological treatment: 1) Improved vision 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 SCENAR-therapy effectiveness in multiple rehabilitation ophthalmological treatment: 1) Improved vision 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 Long-term effects (12 months later) of SCENAR-therapy

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!