Grubnyk N. Prognostificating visual functions in patients with eyeball contusion in accordance with microstructural changes of the retina and choroid (clinical and experimental study)

Object: eyeball contusion. Purpose: to improve prognosticating efficacy of visual functions in patients after eyeball contusion. It can be solved by a differentiated approach of determining the severity degree of retinal and choroidal damages, based on their microstructural changes, observed by spectral optical coherence tomography and electron microscopic studies of the retina and choroid, obtained in the experiment, in the early post-traumatic period. Methods of research: general clinical; ophthalmological (visometry, perimeterу, biomicroscopy, ophthalmoscopy, tonography, spectral optical coherence tomography of choroid and retina, orbital radiography, rheophthalmography, ultrasonography); light microscopy, electron microscopy; statistical. The dependence between visual acuity and changes in the outer nuclear layer (rs = -0,73), external limiting membrane (rs = -0,89), ellipsoid of inner segments of photoreceptors (rs = -0,90), contact cylinder cones (rs = -0.77), retinal pigment epithelium (rs = -0.70) after eyeball contusion is estimated. The classification system and algorithm for assessing the severity of retinal damage after eyeball contusion are developed. The relationship between the central retinal thickness and choroidal thickness in temporal segment was found in severe degree (r = 0,64). The choroidal thinning in the temporal segment by 54.8 μm, in the lower - by 50.8 μm; in the parapapillary temporal - by 28,1 μm and parapapillary lower - by 25,9 μm is established. The method and device for modeling of the eyeball contussion have been developed. Scientific data about degenerative changes choriocapillaries, hydropic and destructive changes in retinal pigment epithelium, photoreceptor cells, muller and ganglion cells are added. The results of the thesis are implemented in the practical work of post-traumatic eye pathology department of the State Institution «The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine» and Medical ophthalmological center of the Odessa National Medical University (University Clinic №2). Scope – medicine, ophthalmology.