Typical Complaints Research Articles

Effect of manual small incision cataract surgery on pre-corneal tear film at a tertiary care centre

A common adverse effect of cataract surgery is dry eye disease (DED), which lowers postoperative patient satisfaction and results in substandard visual acuity. Tear film is disrupted during cataract surgery which leads to dry eye disease. Very few studies are available for the assessment of dry eye following manual small incision cataract surgery (MSICS) among the South Indian population. Hence, this study was conducted to determine the prevalence of dry eye and to evaluate tear film following manual small incision cataract surgery.:A prospective study was carried out in the Department of Ophthalmology at a tertiary care hospital for the assessment of dry eye following MSICS using dry eye indices like tear meniscus height, tear film break up time, Schirmer’s Test 1 and Rose Bengal staining. The patients were assessed preoperatively and at one week, one month and three months postoperatively.:In the first week following manual small incision cataract surgery, 21 eyes (33.3%), 26 eyes (41.3%), and 2 eyes (3.2%) experienced mild, moderate, and severe dry eyes, respectively. One month after MSICS surgery, 22 eyes (34.9%), 19 eyes (30.2%) and 1 eye (1.6%) had mild, moderate and severe dry eye respectively. The mean values of dry eye indices were normal preoperatively and significantly reduced at the one-week and one-month postoperative review.The dry eye illness began to manifest immediately following cataract surgery and peaked on day seven. Over time, symptoms of dry eye was seen to decrease. Despite satisfactory visual recovery, dry eye illness is a typical post-cataract surgery complaint that negatively impacts patient satisfaction and must be assessed and treated promptly.

Prevalence of long COVID complaints in persons with and without COVID-19

We studied the prevalence and patterns of typical long COVID complaints in ~ 2.3 million individuals aged 18–70 years with and without confirmed COVID-19 in a Nation-wide population-based prospective cohort study in Norway. Our main outcome measures were the period prevalence of single-occurring or different combinations of complaints based on medical records: (1) Pulmonary (dyspnea and/or cough), (2) Neurological (concentration problems, memory loss), and/or (3) General complaints (fatigue). In persons testing positive (n = 75 979), 64 (95% confidence interval: 54 to 73) and 122 (111 to 113) more persons per 10 000 persons had pulmonary complaints 5–6 months after the test compared to 10 000 persons testing negative (n = 1 167 582) or untested (n = 1 084 578), respectively. The corresponding difference in prevalence of general complaints (fatigue) was 181 (168 to 195) and 224 (211 to 238) per 10 000, and of neurological complaints 5 (2 to 8) and 9 (6–13) per 10 000. Overlap between complaints was rare. Long COVID complaints were only slightly more prevalent in persons with than without confirmed COVID-19. Still, long COVID may pose a substantial burden to healthcare systems in the future given the lasting high incidence of symptomatic COVID-19 in both vaccinated and unvaccinated individuals.

EMPTY SELLA SYNDROME: THE GREAT IMITATOR OF VISUAL COMPLAINTS

Introduction: Empty Sella Syndrome is a rare condition of sella turcica malformation, resulting in pituitary gland shrinkage. It may manifest as neurological symptoms, endocrine disorders, visual disturbances, or even incidental findings during imaging. However, patients rarely come with typical complaints thus an extended course and review of this case is needed to prompt suspicion and aid in the diagnosis of ESS. Case Presentation: A 45-year-old woman with cephalgia, bitemporal hemianopia, previous transient bilateral visual loss, and foggy vision. A history of ovarian cancer was noted. Physical examination showed myopic astigmatism ocular dextra sinistra (ODS) with increased intraocular pressure and bitemporal hemianopia ODS. Posterior chamber examinations were within normal limits. Optical coherence tomography showed nasal retinal nerve fiber layer ODS being the thinnest among the rest, although still within normal limits. Neurological examinations also suggested the presence of central vertigo. This subsequently resulted in a suspicion of space-occupying lesion chiasmal compression through metastasis. Discussion: MRI revealed an empty sella turcica. A laboratory examination was then ordered and showed normal endocrinology results. The diagnosis of Primary Empty Sella Syndrome with ocular hypertension was established. The patient was prescribed timolol, codeine, and dexamethasone. A month later during her follow-up, the patient did not show improvement and was suggested to do an MRI with contrast, however, this patient was lost to follow-up. Conclusion: This case report highlighted the manifestation to raise suspicion and aid in the diagnosis of ESS for an optimal and improved diagnosis and treatment of ESS.

Predictive value of the systemic immune inflammatory index in cardiac syndrome x

İntroductionPatients with normal coronary arteries in whom increased vasospasm cannot be detected with the stress test should be evaluated in terms of cardiac syndrome x (CSX). İnflammatory systems are effective in endothelial activation and dysfunction in CSX. The systemic immune inflammation index (SII) is thought to be an important factor in determining the course of diseases, especially in infectious diseases or other diseases, as an indicator of the inflammation process. The aim of this study is to determine the role of SII levels in the diagnosis of CSX disease.MethodsThe study group included 80 patients who applied to the cardiology department of Fırat University with typical anginal complaints between October 2021 and April 2022, and were diagnosed with ischemia after the myocardial perfusion scan, and then coronary angiography was performed and normal coronary arteries were observed.ResultsWhen the study and control groups were examined according to age, gender and body mass index, hypertension, smoking, diabetes mellitus, dyslipidemia and family history, no statistical significant difference was observed between the groups. It was observed that there was a significant difference between the high sensitive C- reactive protin levels of the individuals in the study and control groups (p = 0.028). SII levels measured in samples taken from patients were significantly higher than control subjects (p = 0.003). SII cutoff at admission was 582 with 82% sensitivity and 84% specificity (area under the curve 0.972; 95% CI:0.95–0.98;p < 0.001).ConclusionIt has been demonstrated that systemic SII parameters, which can be simply calculated with the data obtained from the complete blood count and do not require additional costs, can contribute to the prediction of CSX disease.

Malignant Peripheral Nerve Sheath Scalp Tumor: A Short-Term Institutional Experience with Literature Review.

Malignant peripheral nerve sheath tumor (MPNST) of the scalp is rare. These lesions are associated with neurofibromatosis type 1 (NF1), but patients had been reported without NF1 also. We tried to analyze the difference between the clinical course and outcome of the patient with MPNST having stigmata of NF1 and without it. We included five patients treated over 3 years between July 2018 and July 2021 with diffuse scalp MPNST. Two of these five patients with MPNST of the scalp had neurocutaneous stigmata of NF1. Three were female and two males with an average age of 38.40 ± 18.48 years-the youngest with NF1 being a 19-year-old female. We found dull aching pain as the most typical complaint in all patients and a repeated episode of generalized seizure in one patient. In these cases, two patients with NF1 have highly vascular tumors and attained large sizes greater than 30 cm. These two cases required preoperative digital subtraction angiography (DSA) and embolization with n-butyl acrylate. Total excision of the tumor was done in all patients with radiotherapy. Metastases within 1 year were noted in two patients with NF1, and one of these two succumbed to her illness. The rest of the three patients without NF1 are under follow-up with no evidence of disease with a maximum follow-up of 2 years. Large MPNST (size > 20 cm) are rare and reported to have been associated with and without NF1. Patients with scalp MPNST with NF1 can achieve larger size with fast progression of tumor size and higher chances of recurrence and metastases.

Malignant Melanoma of Anorectum: A Report of Five Cases

BACKGROUND: Anorectal melanoma (ARM) is an extremely rare, highly aggressive form of a tumor with the worst prognosis. ARM contributes 0.5% of all melanoma cases. Its presentation is similar to that of adenocarcinoma of the rectum, hemorrhoids, or solitary rectal ulcer, the incorrect clinical diagnosis or delayed diagnosis is often made. The definite diagnosis is only made through histopathology in which immunohistochemical stains positive to S-100, Melan A, and HMB-45 which differentiates it from adenocarcinoma of the rectum. Because of the limited number of patients and retrospective design of studies to date, there is no proven efficacy of abdominoperineal resection (APR) over local excision (LE) in terms of survival. Furthermore, this neoplasm is quite resistant to chemoradiotherapy. It has a median survival of 18 months and a 5-year survival rate of only 6%. PRESENTATION OF OUR CASES: Here, we report 5 rare cases of anorectal malignant melanoma presented to our institute between 2018 to 2022, who were treated with APR and diversion colostomy. The first case is a 27-years old young female with typical complaints, she was diagnosed ARM with locoregional metastasis. Only a diversion colostomy was performed and referred to an oncologist for palliation. Our second case is a 68-years old male with a similar complaint who presented relatively early and was diagnosed with localized disease. Conventional APR was performed and referred for adjuvant chemoradiotherapy, but the patient refused. However, the lump recurred after 6 months of tumor excision. The third case is a 29 years old male again early presentation with a similar complaint labeled as localized diseased. The conventional APR was performed followed by adjuvant chemoradiation; patient presented with metastatic disease after 6 months. The fourth case is a 60-years old male with typical history and diagnosed with localized disease. Conventional Extra-levator APR was performed followed by adjuvant therapy, but patient developed recurrence of disease with mets after 4 months. The fifth case is a 39-years old female diagnosed as ARM, had advance disease and metastatic deposits at the time of presentation, refused any palliative treatment. The study aims to evaluate our experience in treating this neoplasm. CONCLUSION: Because of the rarity of this neoplasm, no proper trial has been conducted so far. The role of chemoradiotherapy is questionable and the surgical approach varies from radical APR to conservative LE. No surgical approach has been standardized in terms of survival.

Ectopic pancreas, gastric, duodenal and colonic tissue in a case of persistent umbilical discharge: Report of two patients with review of literature

One of the typical complaints in the pediatric population is umbilical discharge. Among the congenital causes, remnants of omphalomesenteric duct or patent urachus are often detected. On a few occasions, multiple types of ectopic tissue are present. We describe histopathologic findings of two cases reported recently at our center as pediatric umbilical lesions with associated ectopic tissue. Histopathology of the excised mass confirmed the patent omphalomesenteric duct with ectopic gastric, duodenal, and colonic mucosa and pancreatic tissue in two patients with the clinical presentation of umbilical discharge. There were no associated congenital anomalies in these patients. The presence of multiple ectopic gastrointestinal mucosa and pancreas in the umbilical mass is unusual. Herein, we report these cases because of its rarity, multiple ectopic tissues, and reviewing the literature of the reported cases of multiple ectopic tissues.

Risk factors as glaucoma predictors in myopic students

Purpose: identification of early risk factors — predictors of POAG development in students with myopic refraction based on questionnaire and functional test data and the effects of fractal photostimulation (FS). Material and methods. The study involved two clinical groups: the main group of 24 students (48 eyes) with mild to moderate myopia, averagely aged 21.3 ± 0.7 years, and the comparison group (according to FS effects) of 29 patients (58 eyes) with an established diagnosis of stage I–III POAG, averagely aged 58 ± 18 years, and a control group consisting of 66 people (132 eyes, mean age 21.2 ± 1.3 years). The case history of patients and typical complaints were found in questionnaire data. For the two clinical groups, the impact of 10 low-intensity FS sessions was evaluated. Results. A set of features viewed as risk factors for POAG development was determined using the data of the questionaries filled in by the main and comparison groups. The changes in mean IOP values measured before and after an FS course were found to be greater in POAG patients than in myopic students. FS was shown to contribute to IOP stabilization in patients with pre-existing morphological and functional glaucoma changes and the occurrence of accompanying pathologies such as vasospasm, blood pressure fluctuations, and migraine-like pain. After a course of FS, overall photosensitivity increased significantly as compared with the baseline in students with mild and moderate myopia (p &lt; 0.05). Also, a positive effect of an FS course on MD indices in patients with stages IIa and IIIa POAG was confirmed. Conclusion. The research results confirm the need to identify clinical and functional predictors of POAG with a progressive glaucomatous process in students with myopic refraction.

Post-covid medical complaints following infection with SARS-CoV-2 Omicron vs Delta variants

The SARS-CoV-2 Omicron (B.1.1.529) variant has been associated with less severe acute disease, however, concerns remain as to whether long-term complaints persist to a similar extent as for earlier variants. Studying 1 323 145 persons aged 18-70 years living in Norway with and without SARS-CoV-2 infection in a prospective cohort study, we found that individuals infected with Omicron had a similar risk of post-covid complaints (fatigue, cough, heart palpitations, shortness of breath and anxiety/depression) as individuals infected with Delta (B.1.617.2), from 14 to up to 126 days after testing positive, both in the acute (14 to 29 days), sub-acute (30 to 89 days) and chronic post-covid (≥90 days) phases. However, at ≥90 days after testing positive, individuals infected with Omicron had a lower risk of having any complaint (43 (95%CI = 14 to 72) fewer per 10,000), as well as a lower risk of musculoskeletal pain (23 (95%CI = 2-43) fewer per 10,000) than individuals infected with Delta. Our findings suggest that the acute and sub-acute burden of post-covid complaints on health services is similar for Omicron and Delta. The chronic burden may be lower for Omicron vs Delta when considering musculoskeletal pain, but not when considering other typical post-covid complaints.

Transit Customer Acceptance of Automated Fare Collection Systems

The Chicago Transit Authority (CTA) inaugurated an Automated Fare Collection (AFC) system in Fall 1997. More than 1 million daily rides now utilize AFC to access CTA’s bus and rail service networks. While this represents about three-fourths of all CTA riders, many have stayed with cash or tokens (though the latter are now being phased out); monthly passes have been fully integrated with the farecard technology.This article provides a one-year perspective on customer reactions to, acceptance of, and problems with the new AFC system. It examines “before” and “after” shifts among the various fare media options available, and discusses major differences for bus and rail customers regarding ease of purchasing automated farecards and the resultant greater usage levels for rail as compared to bus. This article also reviews behavior in purchasing precoded, fixed-value farecards; buying variable-value farecards at automated vending machines (AVMs) located at rail stations; and recharging previously purchasedfarecards at those AVMs. Systemwide customer satisfaction surveys conducted in 1995 and 1997 found that satisfaction ratings, particularly among bus riders, significantly improved for several different fare-related service attributes. Transactions handled by rail station customer assistants, the CTA customer service hot line, and its AFC express unit desk, in dealing with customer questions/problems regarding the new AFC equipment, are also discussed. Typical weekday complaint levels related to AFC—especially those involving refund requests—are quite modest, but require sustained levels of courtesy and quick response.

Common cold remedies

COVID-19 may have pushed the common cold out of the limelight, but we're about to enter a new cold season. While there is a vaccine for COVID-19, there is no vaccine or cure for the common cold. Some patients, with typical complaints of congestion, runny nose, sore throat, coughing, and sneezing, may reach for remedies like echinacea, ginger, or zinc. But do any of these help?

Оn the issue of diagnosis of Norwegian scabies on the example of a clinical case

Norwegian scabies is a rare form of a fairly common contagious skin disease. It is characterized by difficulties in diagnosis due to the absence of a typical clinical picture and characteristic complaints of the patient. Also, the diagnosis of Norwegian scabies is often complicated by the presence of concomitant diseases, such as ichthyosis and mental retardation. As a result of impaired cognitive functions in patients, it is quite problematic to collect complaints and anamnesis. An incorrect diagnosis leads to the appointment of ineffective therapy and, as a result, to further progression of the disease, accompanied by the addition of secondary infection and deterioration of the general condition of the patients body.&#x0D; Training of doctors of various specialties (dermatovenerologists, therapists and general practitioners) in the skills of differential diagnosis of Norwegian scabies is relevant due to the increase in cases of this disease in various groups of people, mainly related to boarding houses and long-stay hospitals.&#x0D; In this article, the authors provide an overview of the etiology, pathogenesis, and clinical manifestations of a rare form of scabies ― Norwegian scabies, and highlight the difficulties of differential diagnosis of this dermatosis. A clinical case of Norwegian scabies in a 52-year-old woman suffering from ichthyosis and mental retardation on the background of Down syndrome is described.

CLINICAL CASE OF CORONAVIRUS DISEASE COMBINED WITH INFECTIOUS MONONUCLEOSIS IN CHILDREN

The article presents a clinical case of coronavirus disease in a child, combined in time with infectious mononucleosis. Today there is a growing tendency in the prevalence of diseases caused by herpes viruses. At the same time there is an increase in the incidence of infectious mononucleosis. The level of Epstein-Barr virus infection among the adult population of Ukraine has reached almost 100%, and more than 50% among the children. The number of children confirmed by COVID-19 is growing with each passing wave, and coronavirus disease is dangerous for young children with a high probability of complications and hospitalizations. The first manifestations of the disease were not typical: fever, nausea, periorbital edema. A week later, typical mononucleosis complaints of sore throat, "nasality", raids on the tonsils and enlargement of the tonsils appeared. Additional examinations revealed an increase in ALT and AST, an increase in the liver. The diagnosis was made on the basis of detecting an increase in the level of specific immunoglobulins to SARS-Cov-2 and EBV. The coronavirus disease can initiate the manifestation of persistent viruses, in particular EBV

Acute myocardial infarction (AMI) in a patient with Human Immunodeficiency Virus infection

Introduction: Recent studies have shown that in HIV patients, the incidence of acute myocardial infarction is up to two times higher than in people who are not infected with HIV. HIV patients presenting with the first episode of the acute coronary syndrome are, on average, a decade younger than the general population, more frequently in men and current smokers. Case Report: We report a case report of a 33-year-old man with a diagnosis of anteroseptal STEMI and recent HIV on first-line ART, a combination of zidovudine 300 mg and lamivudine 150 mg, plus efavirenz 600 mg. The patient had typical angina complaints and had risk factors, namely smoking and a history of dyslipidemia. Patients were treated according to acute coronary syndrome guidelines, given DAPT, heparinization for five days, statins, anti-ischemia, ACE-I, and DCA-PCI. The DCA-PCI result in this patient was CAD 1 VD with 1 DES installed in the proximal LAD (complete revascularization). The patient was discharged from the hospital after seven days of treatment. Prognosis in these patients is still quite good, but preventing recurrent myocardial infarction needs risk factors and control for successful myocardial infarction therapy and ART. Conclusion: Special attention should be given to the risk of myocardial in HIV patients. Early diagnosis and prompt treatment could significantly lower mortality and improve patients' quality of life.

Баланопостит в клинической практике: оценка эффективности комплекса Баланекс.

Introduction. Despite the frequent occurrence of balanoposthitis, due to the wide variety of pathogens, it is often difficult to find an effective therapy. Purpose. To evaluate the extent of changes in complaints during therapy by the complex drug Balanex and its effectiveness. Materials and methods. The study was conducted as a prospective comparative cohort. The study included 120 patients with typical complaints for balanoposthitis. Patients were randomized according to chronic diseases and balanoposthitis therapy. The first group included 59 men with nonspecific balanoposthitis, for whom Balanex cream gel was prescribed topically 2 times a day as a therapy. The study observation group consisted of 32 men with balanoposthitis on the background of diabetes mellitus, for whom therapy Balanex cream gel was prescribed topically 2 times a day. The control group included 29 men with nonspecific balanoposthitis, for whom therapy by a combined cream (antibacterial + antifungal component) was used topically 2 times a day. Results and discussion. In all patients, the results of repeated microbiological examination were negative. The time of disappearance of the patient's disturbing symptoms ranged from 2 to 7 days, on average it was 3.2 ± 1.1 days, the median value was 3 days. At the same time, the presence of diabetes mellitus in the patient significantly prolonged the period of disappearance of symptoms to 3.9 days. The average value of this indicator was 3.0±0.6 vs. 3.9±1.6 vs. 3.0±0.8 days (p&lt;0,001). Conclusions. Balanex cream gel significantly and comparably with the combined cream reduces the severity of symptoms that occur with balanoposthitis, including patients with diabetes mellitus.

Whom Should We Screen for Cushing Syndrome? The Endocrine Society Practice Guideline Recommendations 2008 Revisited

ContextCushing syndrome (CS) is a rare and serious disease with high mortality. Patients are often diagnosed late in the course of the disease.ObjectiveThis work investigated whether defined patient populations should be screened outside the at-risk populations defined in current guidelines.MethodsAs part of the prospective German Cushing registry, we studied 377 patients with suspected CS. The chief complaint for CS referral was documented. Using urinary free cortisol, late-night salivary cortisol, and the 1-mg dexamethasone suppression test as well as long-term clinical observation, CS was confirmed in 93 patients and ruled out for the remaining 284.ResultsPatients were referred for 18 key symptoms, of which 5 were more common in patients with CS than in those in whom CS was ruled out: osteoporosis (8% vs 2%; P = .02), adrenal incidentaloma (17% vs 8%, P = 0.01), metabolic syndrome (11% vs 4%; P = .02), myopathy (10% vs 2%; P < .001), and presence of multiple symptoms (16% vs 1%; P < .001). Obesity was more common in patients in whom CS was ruled out (30% vs 4%, P < .001), but recent weight gain was prominent in those with CS. A total of 68 of 93 patients with CS (73%) had typical chief complaints, as did 106 of 284 of patients with ruled-out CS status (37%) according to the Endocrine Society practice guideline 2008.ConclusionThe 2008 Endocrine Society Practice guideline for screening and diagnosis of CS defined at-risk populations that should undergo testing. These recommendations are still valid in 2022.

Optimization of an integrated approach to voice correction for endocrinopathies (analytical review)

Dysphonia is a symptom of many endocrine pathologies. Hoarseness, voice fatigue, decrease of the voice pitch, reduce of the range are typical complaints for hypothyroidism, caused by an increased amount of polysaccharides and accumulation of fluid in the lamina propria of the vocal folds. An excess of growth hormone causes an overproduction of insulin-like growth factor-1, which leads to abnormalities in thecraniofacial region and proliferation of the upper respiratory tract tissues, including thickening of the laryngeal cartilages, vocal folds and decreasing of the voice pitch. Hyperglycemia, changes in the balance of fluid and electrolytes in diabetes mellitus can indirectly affect the voice: xerostomia complicates phonation due to impaired hydration of the laryngeal mucosa, diabetic neuropathy often disrupts the work of the laryngeal muscles involved in voice formation. Voice changes are observed not only in endocrine disorders, but also during puberty, the phases of the menstrual cycle and during menopause. Laryngeal structures are modified under the influence of hormones and external factors, which generally changes pitch and intensity of the voice, timbre and resonance, articulation and prosodic characteristics. The purpose of this review is to summarize and systematize data on physiological and pathological voice changes in patients of different age groups and sex. The possibilities of a multidisciplinary approach to rational voice correction are demonstrated.

Massive gastrointestinal bleeding due to rectovaginal fistula: A rare case report

Rectovaginal fistula is usually observed due to obstetric traumas during giving birth, rectal or gynecologic malignities or after surgical therapy of malignant lesions or radiotherapy. Rectovaginal fistulas are not common in general surgery and gynecology clinics. However, these lesions are rarely seen during gastroenterology practice. In gastroenterology practice, we may face with rectovaginal fistula during Crohn’s disease’s course. These lesions deteriorate patients’ quality of life and increase morbidity and mortality. Endoscopy may be used to detect the localization of fistula and may help to choose correct treatment modality. Endoscopy sometimes may also be used to treat rectovaginal fistula via endoclips or stents. Typical complaints for rectovaginal fistulas are air, gas, or mucus discharge from vagina. Dyspareunia, perineal pain, or recurrent vaginal infections may also be seen. Rectal bleeding is not a common complaint for rectovaginal fistulas. Herein we report a rare case with rectovaginal fistula presenting with massive rectal bleeding after debulking surgery for ovarian carcinoma.

Клинические аспекты ларингофарингеального рефлюкса

Laryngopharyngeal reflux (LPR) as the cause of symptoms in the absence of symptomatic gastroesophageal reflux disease (GERD) is often questioned. But it is worth remembering that GERD is a whole complex of symptoms that occur when the mucous membrane is damaged. We aimed to study the clinical symptoms of LPR without esophageal symptoms. The study included 66 women and 34 men with complaints typical of LPR, aged 18 to 70. The study included patients with typical LPR complaints without esophageal symptoms who rated them at more than 13 points according to the RSI questionnaire. 91 patients (95%) complained of hoarseness; 93 (97%), of a sore throat; 88 (92%), of excessive mucus coughing up or its running off from the nose; 36 (38%), of difficulty swallowing; 43 (45%), of coughing after eating or after lying down; 68 (71%), of shortness of breath or episodes of suffocation; 64 (67%), of excruciating or hacking cough; 84 (88%), of feeling of something sticky in the throat or a lump in the throat. In addition to the typical symptoms of LPR, patients may experience difficulty in nasal breathing; sneezing in the absence of respiratory allergies; burning and bitterness in the mouth; bad breath due to the formation of tonsilloliths; complaints from the ear not recorded by objective methods of research. 23% of patients with LPR suffer from carcinophobia. We concluded that LPR affects the larynx and all parts of the pharynx. The appointment of omeprazole 20 mg 30 minutes before meals in the morning 1 time per day for 6 weeks significantly reduces the symptoms of LPR. A new questionnaire is required for the early detection of LPR symptoms by a questionnaire method.

Комплексная терапия синдрома «сухого глаза» на фоне хронического периферического увеита

Aim: to study clinical presentations of dry eye disease (DED) in intermediate uveitis (pars planitis) and develop a complex treatment algorithm including tear substitutes, reparative, and anti-inflammatory therapies combined with laser photocoagulation. Patients and Methods: the study enrolled 98 patients divided into the study group (n=78) and the comparison group (n=20). Study group patients received complex treatment, including tear substitutes, anti-inflammatory therapies, and laser photocoagulation. Comparison group patients received topical medications only. All patients underwent a complex examination including the OSDI questionnaire, visual acuity, IOP measurements, slit lamp examination, binocular dilated fundus examination with scleral indentation, and Schirmer’s test 1 at baseline, after baseline three and six months. Treatment efficacy was assessed based on the severity of intermediate uveitis presentations. Results: intermediate uveitis exacerbates DED. The more active chorioretinal inflammation near the ora serrata is, the more severe clinical, functional changes of the ocular surface are. Complex treatment significantly improved typical DED complaints by the OSDI score (by 34.8%), ocular surface by slit-lamp examination (lower occurrence of conjunctival fold overhang, by 51.8%), mild eyelid and conjunctival hyperemia, and conjunctival discharge. Six months after treatment, a 2-fold (vs. baseline) increase in total tear secretion and resorption of vitreous exudates and retinal edema were reported in the study group. Changes in all parameters in the study group were more significant than in the comparison group. Conclusion: complex treatment algorithm (tear substitutes, reparative, and anti-inflammatory therapies combined with laser photocoagulation) provides a more rapid and stable reduction in chorioretinal inflammation near the ora serrata. It significantly improves subjective and objective DED signs compared to conventional pharmacotherapy. Keywords: dry eye disease, intermediate uveitis, laser photocoagulation, ora serrata. For citation: Tatarnikova E.B., Krivosheina O.I. Complex treatment for dry eye disease in intermediate uveitis. Russian Journal of Clinical Ophthalmology. 2022;22(1):30–35 (in Russ.). DOI: 10.32364/2311-7729-2022-22-1-30-35.