1. Human fetal eyeball layers’ structure, differentiation and vascularization
Battulga G ; Uranchimeg D ; Amgalanbaatar D
Innovation 2015;9(Ophthalmology):28-32
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.
2. DEGREE OF CORONARY ATHEROSCLEROSIS IS ASSOCIATED WITH CHANGING CIRCULATING LEVELS OF ENDOTHELIN RECEPTOR TYPE A IN MONGOLIAN ADULTS
Purevjargal L ; Nandin G ; Ayurzana A ; Haliun N ; Shine-Od ; Uranchimeg D ; Avirmed A ; Enebish S ; Amgalanhaatar D ; Lkhagvasuren ; Erdenebayar.N
Innovation 2013;7(3-S):73-76
Background:The cardiovascular disease especially coronary artery disease is the leading cause of mortality in worldwide. There is lack of research study which evaluated stenosis of coronary atherosclerosis. It is known that coronary stenosis is highly connected to the levels of biomarkers. Coronary atherosclerosis correlated with endothelin receptor type A (EDNRA) levels in a group of patients suspected of having coronary artery disease.Objective:The goal of this study was to evaluate the relation between the coronary atherosclerosis and levels of EDNRAMethods:A total of 311 participants were involved in this study. A case-control study was used in the study. The baselines data were collected from the department of Angiography at the National Third Central Hospital and National lilood Transfusion and Research center. We have determined the degree of coronary atherosclerosis using the Angiography machine and Elisa were used for detecting the blood endothelin levels in all groups.Results:98 participants were diagnosed with stenosis and occlusion. The blood endothelin levels were estimated to 6.32±0.64 pg/ml which refer to () degree of coronary stenosis, the first degree of stenosis of coronary atherosclerosis is estimated to 5.56±0.22pg/ml, the second degree of stenosis of coronary atherosclerosis is estimated to 5.42J0.34 pg/ml, the third degree of stenosis of coronary atherosclerosis is estimated to 5.87 H). 13 pg/ml, the fourth degree of stenosis of coronary atherosclerosis is I'SlilllSltll lo 5.69±0.09 pg/ml, it was estimated to 5.88±0.13 pg/ml in control groups. Level of EDNRA (occupying one segment of coronary artery) was estimated to 5.77±0.08 pg/ml. two segment involvement was estimated to 5.72±0.16 pg/ml, three segment involvement 5.73±0.19 pg/ml. four segments involvement 5.50±0.25 pg/ml, respectively.Conclusion:The blood endothelin level and coronary artery stenosis were not correlated statistically significant in control group of the study. However, blood endothelin levels were increased in patients who tend to experience the coronary artery stenosis.
3. Hemangioma cases and treatment
Davaanyam L ; Ayanga G ; Erdenetsogt J ; Tserendulam D ; Bayasgalan R ; Batbayar B ; Uranchimeg D ; Bulgantamir E
Innovation 2016;2(1):18-20
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.
4.Aetiology of congenital pediatric cataract in Mongolia
Shamsiya M ; Urantsetseg D ; Uranchimeg D ; Davaa G
Innovation 2019;13(1-Ophthalmology):18-22
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.
5. Clinical and pathological analysis of rejection cases after kidney transplantation
Enkhtamir E ; Galtsog L ; Ulzii-Orshikh N ; Bayambadash B ; Munkhjargal B ; Od-Erdene L ; Uranchimeg B ; Saruultuvshin A ; Chimidtseren S ; Tsogtsaikhan S ; Batbaatar G ; Munkhzol M
Innovation 2016;10(2):48-51
Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.
6.Trifocal intraocular lens implantation to treat visual demands in Mongolian patients
Narangarav G ; Tsendjargal G ; Davaa D ; Uranchimeg D
Mongolian Medical Sciences 2023;203(1):17-21
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.
7.VEGF-A and ARMS2 gene polymorphism on AMD susceptibility
Ariunzaya A ; Chimedlkhamsuren G ; Suvd T ; Sarantuya J ; Uranchimeg D ; Baasankhuu J
Innovation 2019;13(1-Ophthalmology):10-13
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.
8.Clinical features of ophthalmology in thyroid disease
Oyungerel B ; Erdenezul G ; Misheel B ; Uranchimeg D ; Chimedlkhamsuren G ; Nomin-Erdene M ; Sarantuya J
Innovation 2021;14(2-Ophthalmology):6-10
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.
9.Investigation of morphometric measurement of the eyelid and ocular axial position in Mongolian adults
Oyungerel B ; Lkhagvadulam Ts ; Sumyasuren U ; Misheel B ; Lkhagvadulam U ; Bundarkhi Kh ; Undarmaa Sh ; Uranchimeg G ; Sarantuya J
Innovation 2022;15(1-Ophthalmology):18-23
Background:
The shapes of the eye and upper eyelid are distinctive facial landmarks. The palpebral fissure is composed of the free edges of upper and lower eyelids the lateral and medial canthus. Many
researchers confirmed that the morphometric characteristics of the palpebral fissure, canthal distance
and exophthalmometirc value (EV) vary according to race, ethnicity, age and sex and normative values
which may serve as a reference in the index population. Knowledge of normal dimensions, the existence of asymmetry of the palpebral fissure is of value in several clinical specialties including ophthalmology, plastic and reconstructive surgery and traumatology, where it plays a part in the patient evaluation, management and outcomes.
Methods:
This cross-sectional study was conducted in the Ophthalmological Department, Third State Central
Hospital between January 2022 and August 2022. We included participants who are above 18 years, no history of congenital or traumatic craniofacial deformities, any orbital fractures, tumors and surgeries. All measured values that represent eyelid shape and EV were calculated by mean and standard deviation for statistical analysis.
Results:
A total of 103 participants aged 19-86 were included in the study, of which 44 (42.7%) were male
and 59 (57.3%) were female. The distance between the lateral and medial canthus ranged from 20 to 35 mm, and the mean of the right and left side was 28.30+3.23 mm and 28.05+2.99 mm, respectively (p=0.561). The palpebral fissure height ranged from 5 to 13 mm, and the mean of the right and left side was 8.85+1.65 mm and 8.80+1.65 mm, respectively (p=0.816). The mean distance between the lateral canthi were 90.39+5.57 (range: 80-105 mm), whereas the mean distance between the medial canthi were 63.75+4.25 (range: 53-73 mm). The orbital height varied between 27-43 mm (33.73+3.72) and 26-44 mm (33.78+3.73) on the right and left sides, while the orbital width varied between 26-47 mm (36.75+4.53) and 27-45 mm (36.72+4.42) on the right and left sides, respectively. When measuring the exophthalmometric value (EV), the axial position of the eyeball, with the Hertel’s exophthalmometer, it ranged from 8 to 20 mm on both sides (mean value 13.68+3.01 and 13.71+3.00 on the right and left sides, respectively), and there was no statistically significant difference in symmetry (p=0.94).
Conclusion
The results are determined different from the findings of Chinese, Korean, Afro-American and
Caucasian population based studies. Thus further evaluation is required to represent the normative value of Mongolian index population, that is highly beneficial for clinical assessment, diagnosis and management.