Background: Central serous chorioretinopathy (CSCR) is described by researchers as a condition that results from fluid under the retinal pigment epithelium, originating from the choroid of the eye. This disease usually affects the central part of vision and may resolve on its own over time, though in some cases, it can persist for long periods or recur. In our country, there is a lack of research regarding this condition, which led to the motivation for gathering and reviewing existing works on this topic. Aim: To collect and analyze a review of the studies on central serous chorioretinopathy (CSCR). Methods: We reviewed and analyzed literature related to CSCR published in electronic sources such as Thomson Reuters, PubMed-central database, and Google Scholar using literature review methods. Results: CSCR is most commonly seen in individuals aged 35-55 years, with a significantly higher prevalence in men (9.9/100,000) compared to women (1.7/100,000). Researchers found that the prevalence of CSCR is nearly the same among populations in Europe, Africa, and Asia. CSCR typically affects one eye, but it occurs in both eyes in up to 40% of cases. Weenink A (2001) studied the family members of 27 patients with bilateral CSCR, finding that 52% of family members had been diagnosed with CSCR, and 27.5% of them had chronic CSCR in at least one eye. This suggests a potential genetic predisposition to CSCR. According to researchers, while CSCR can be diagnosed clinically, additional imaging techniques like fluorescein angiography and optical coherence tomography are frequently used to rule out other diagnoses and guide treatment. Conclusion CSCR generally has a favorable prognosis, but recurrences and its effects on visual function indicate the need for effective management strategies. To maintain long-term visual improvement, it is essential to provide healthcare services tailored to the patient’s specific conditions and risk factors.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

Neuromyelitis optica (NMO) is an autoimmune, inflammatory, demyelinating disorder characterised by attacks within the spinal cord and optic nerve. The purpose of this review is to understand the evidence for the effectiveness of plasmapheresis as an add-on therapy for NMO spectrum disorders (NMOSD). The current diagnostic criteria for NMO include optic neuritis, acute myelitis, and at least two of the following three supportive criteria: contiguous spinal cord MRI lesions extending over ≥3 vertebral segments, brain MRI not meeting diagnostic criteria for multiple sclerosis, and NMO-seropositive status.⁵ Myelitis presents with paraparesis and sensory loss below the lesion, sphincter loss, dysaesthesia, and radicular pain.

Background: Worldwide, the leading cause of blindness in people over the age of 50 is age-related macular degeneration (AMD), which is a complication of the exudative “wet” and dry type. AMD is a multifactorial neurodegenerative disease relating with a combination of environmental and genetic factors, and a contribution of age effect and smoking also, obesity was investigated to be associated with the disease. Number of previous studies have shown that the polymorphisms in the ARMS2, CFH and VEGF-A genes are associated with AMD. Therefore, we investigated the associations between the five common vascular endothelial growth factor (VEGF) polymorphisms and AMD with its therapeutic results. Materials and Methods: Totally 161 AMD patients and 223 controls were enrolled in this case-control study. A prospective analysis of 66 eyes of 34 patients with neovascular AMD evaluated intravitreal bevacizumab injections. The polymorphisms in CFH, ARMS2 and VEGF-А were detected by using the methods of allele-specific polymerase chain reaction (ASPCR) and PCR based restriction fragment length polymorphism (RFLP). Statistical analyses were performed by SNPalyze software. Results: Results of the study showed that rs1061170, rs1065489, and rs800292 polymorphisms are associated with arterial hypertension. Anti-coagulant intake rs1061170 polymorphism T/C, C/C/C/C risk genotype (OR=5.04, 95% CI, 1.81-14.09, p=0.002, RERI=2.568, AP=0.509, S=2.7302) , combined effect of G/C/C/C/ /G, G/A risk genotype (OR=6.52, 95% CI, 2.88 14.79, p<0.001, RERI=4.187, AP=0.642, S=4.136) are associated with increased risk of AMD. In the study, in 66 eyes of a total of 34 people who received intravitreous injection treatment, the central retinal thickness before and after treatment was 294.59±83.52 before treatment, 262.74±87.02 on the first day after treatment, 259.5±111.83 after one month, 248.98±84.96 after 3 months, and 262.69 after 6 months. ±110.59, after 1 year it decreased to 259.19±112.29 (95% CI, 226.74-291.65), which is a statistically significant difference. A comparative study of polymorphisms in therapeutic and non-therapeutic groups revealed statistically significant differences in the G/G groups of rs2010963 polymorphisms. Also, people with G/G genotype of rs2010963 polymorphism are more effective in treatment than people with other genotypes. Conclusion Individual factors such as not wearing sunglasses and arterial hypertension and using anti coagulant medication have been identified as risk factors for AMD. The result showed that polymorphisms of ARMS2, CFH, VEGF genes can be a genetic risk factor for AMD. The decreased in central retinal thickness and improving VA after anti-VEGF treatment confirm the effectiveness of the treatment. Also, people with G/G genotype of rs2010963 polymorphism are more effective in treatment than people with other genotypes. Identification of genetic markers that affect clinical response may result in optimization of anti-VEGF therapy.

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.

Introduction: Endometritis (EMM) is the most common maternal infectious complication of childbirth, occurring more commonly after low transverse cesarean section (LTCS) than vaginal delivery [1]. In a Cochrane review, the mean incidence of EMM following elective cesarean section was 7% and after non-elective or emergency operations was 30% [4]. A variety of independent risk factors for post-cesarean EMM have been identified in previous studies, including no prior cesarean section [5], low infant Apgar scores [6], trial of labor [7], premature rupture of membranes (PROM) >24 hours, young maternal age [8], preterm or post-term gestation [9], antepartum infections [10], pre-eclampsia, meconium [11], amnion infusion, postpartum anemia, multiple vaginal examinations [12], and manual removal of the placenta [13]. The time of ruptured membranes before delivery is examined via dichotomized time thresholds, the risks of chorioamnionitis and endomyometritis are significantly increased at 12 hours and 16 hours, respectively [16, 17]. A change in policy to administer prophylactic antibiotics before skin incision led to a significant decline in postcesarean delivery surgical-site infections [18, 19]. Objective: To determine independent risk factors for EMM following (LTCS). Material and Method: The study was case-control study, between 2022 to 2023 years at the “Urguu” specialized maternal hospital Ulaanbaatar, Mongolia. Case group has 101 women with EMM and the control group has 100 women with non EMM after LTCS. Results: The age of 2 study groups was 32.4 and 32.8, body mass index was 30 kg/m2 and 30.7 kg/ m2.Young maternal age <25 has a 22% (p=0.001, OR=4.5) influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. (p>0.05). Delivery risk factors has increases the EMM by 15% (p=0.002), labor induction by 20% (p=0.001), duration of labor >12 hours by 40% (p=0.001), PROM increased by 15% (p=0.005), meconium by 15% (p=0.005), chorioamnionitis by 15% (p=0.001). Conclusion Our study, young maternal age <25 has influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. Delivery associated risk factors are affected by the EMM after LTCS. The labor after LTCS, labor induction, PROM >12 hours, duration of labor, number of vaginal exams>4, meconium, chorioamnionitis increased by EMM. Young maternal age (<25) increased the risk of EMM attached with labor association risk factors.

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.

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.

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.

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.