FEATURES HEMODYNAMIC AND MORPHOMETRIC CHANGES OF THE OPTIC DISC IN PATIENTS WITH OPTIC NEUROPATHY AT HIGH COMPLICATED MYOPIA
Keywords:optic neuropathy, high complicated myopia, peripapillary nerve fi bers, eyes hemodynamics
Summary. Complicated high myopia with optic neuropathy is one of the reasons for the progressive reduction of visual functions. Changes in hemodynamic parameters myopic eyes, microcirculation disturbances, leading to tissue ischemia posterior segment of the eye, have a damaging effect on the optic nerve, and the nerve fi bers in the perineural region, followed by the development of optic neuropathy.
Purpose. Improving the quality of diagnosis of optic neuropathy with high complicated myopia by determining the characteristics of hemodynamic and morphometric changes in the optic disc at this nosology.
Materials and Methods: The study included 115 people (158 eyes) aged from 17 to 38 years (mean 27,3±3,4 years) with optic neuropathy in the background of complicated high myopia. The comparison group consisted of 25 people (50 eyes) with emmetropia, myopia and hyperopia up to 0.75 diopters without clinically signifi cant ophthalmopathology. Apart from the general ophthalmic examination was performed ophthalmic artery Doppler, were studied morphometric parameters of the optic disk on the machine HRT II.
Results and discussion. The anteroposterior size of the eyeball from the main group ranged from 25.10 mm to 29.40 mm and the average was 26,93±1,08 mm. The value of anteroposterior size comparison group of patients ranged from 22.10 mm to 24.70 mm and the average was 23,36±0,95 mm.
All myopic patients with optic neuropathy have been marked changes in visual function, manifested decrease corrected visual acuity on average by 40%, narrowing the total fi eld of view of 14%, an increase of 35% threshold of electrical sensitivity of phosphine relatively similar results in the comparison group.
In addition, the development of optic neuropathy at high complicated myopia is characterized by a decrease in the area neuroretinal rim to an average of 1,39±0,06 mm² (by 5.4%), volume neuroretinal rim to an average of 0,36±0,05 mm³ (by 32%), the thickness of the peripapillary nerve fi bers to an average of 0,13±0,02 mm (by 48%, p <0.05), the average area of peripapillary nerve fi bers to 0,68±0,05 mm² (by 39.3%, p<0.05).
Hemodynamic changes in the study group was to reduce systolic blood fl ow velocity in the ophthalmic artery in average 31,2±1,12 cm/s (20.2%, p<0.05), diastolic velocity – up 7,4±0.85 cm/s (8.4%).
Myopic patients had severe and moderate correlations between functional, morphometric and hemodynamic parameters of the visual analyzer and the magnitude of the anterior-posterior axis of the eye.
Conclusion. 1. The optic neuropathy at complicated high myopia is characterized by a decrease in corrected visual acuity of 36.4%, narrowing the total fi eld of view of 16.0%, the absolute appearance in 20.1% of cases and relative cattle at 36.7% of patients, while the severity of these of pathological changes correlate with the degree of increase in the size of the MSP eyeball.
2. The features of morphometric parameters of the optic disc in patients with optic neuropathy with high myopia complications are decrease in area and volume of neural rim of 6.8% and 32.1%, respectively, decrease in thickness and extent of peripapillary nerve fi bers by 44.0% and 38.4 %, respectively.
3. Change in functional and morphometric parameters in eyes with optic neuropathy in myopia comes amid slowing systolic and diastolic blood fl ow velocities in the ophthalmic artery in the 21.7% and 8.3%, respectively, reducing the pulse index – 6.9%.
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