Petrushenko D. Provision of Experimental and Clinical Rationale for Retrobulbar Tissue Detoxification in Combined Treatment of Toxic Alcohol Neuroretinopathy

Object of study: Toxic аlcohol neuroretinopathy. Objective: To improve the efficacy of toxic аlcohol neuroretinopathy (TAN) treatment by development of retrobulbar tissue detoxification method based on the experimental investigation of acetaldehyde accumulation in retrobulbar tissue (RBT) and estimation of its elimination following detoxification therapy. Methods: vision acuity study, colour vision study, visual contrast sensitivity estimation, computer perimetry, chromoperimetry, biomicroophthalmosсopy, dopplerography, ELISA, capillary gas chromatography, microscopy х400 and х1000, cytophotometry, methods of statistical analysis; ultrasound diagnostic device Toshiba "Aplio" , ELISA analyzer-photometer Immuno-Chem-2100, chromatograph "Cristal 2000М", microscope Olympus BX-41. For the first time depositing of acetaldehyde in the retrobulbar tissue in chronic alcohol intoxication with elevated acetaldehyde levels in the retrobulbar tissue for at least 4 weeks of alcohol deprivation without treatment was proved by the experiment. Data on retrobulbar tissue acetaldehyde toxic effects on alteration and regeneration processes in the retina, choroid and optic nerve in chronic alcohol intoxication and possible impact of the combined treatment with polyoxidonium by intravenous drop infusion and endonasal electrophoresis on these processes were added. Data on the hemodynamics of the eye and orbit in toxic alcohol neuroretinopathy were added. Doppler characteristics of toxic alcohol neuroretinopathy stages were specified. The main feature of the stage of hyperemia was the rise in venous blood flow velocities in the eye and orbit which reflected activation of compensatory mechanisms. The stage of swelling was distinguished by the decrease in blood flow velocities in the superior orbital vein and the changes in spectral waveform in the central retinal artery which had a character of "splashes". The main difference of the stage of dystrophy was the appearance of the signs of artery-venous shunts. Elimination of acetaldehyde from retrobulbar tissue in the treatment of toxic alcohol neuroretinopathy was pathogenetically provised. The method of combined treatment with polyoxidonium by intravenous drop infusion and endonasal electrophoresis for detoxification of RBT in comprehensive therapy of TAN was developed. The results of the thesis were implemented in practice in Sumy Regional Hospital, Sumy Railway Clinic, Kharkiv City Clinical Hospital №14. They were also used in study process at the Ophthalmology Department of Kharkiv Medical Academy of Postgraduate Education. Scope - medicine, ophthalmology.