The thesis is devoted to the problem of increasing the effectiveness of myopia progression prophylaxis, by clinical-experimental substantiation of drugs differentiated administration for correction of eye hydrodynamics and scleral morphogenesis.
Supplemented scientific data on the features of hydrodynamics of the eye in children with progressive myopia, in particular − it was established that there is an increase in the values of real intraocular pressure (P0) up to 14,27 ± 0,23 mm Hg (in the group of control − 12,29 ± 0,30 mm Hg), hydrodynamic changes are more pronounced in the group with rapidly progressive myopia and the degree of these changes increases with the age of the child – in the elderly group P0 increased on 30,9 % comparing to the group of control. Correlation-regression analysis revealed a very high direct relationship between the annual myopia progression gradient and the Becker coefficient and a high direct correlation between the annual gradient of myopia progression and the values of P0.
Supplemented scientific data on structural changes of the retina in the macula with progressive myopia, which consist in the relative increase in the thickness of the retina in the center of the fovea, on 8,9 % in comparison with emetropes, reduction in the thickness of the ganglion complex GCL++ on 7,5 % and 4,0 % in comparison with emetropes and with patients with slowly progressive myopia respectively. These changes are accompanied by the dispersion of the external plexiform layer and the Henle fiber layer in the macula against the background of a decrease in the density of vessels of the surface capillary plexus in patients with rapidly progressive axial myopia, compared with emetropes on 4,5 % in nasal and 5,0 % in temporal sectors of macular region.
For the first time, the asymmetry of the structural rearrangements of the optic nerve disc and the papillomacular region in the rapidly progressive axial myopia were proven according to the data of SS-ОКТ, which manifests itself in reducing the angular characteristics of the optic nerve disc on 16,4 % and 15,3 %, and an increase in retinal-choroidal coefficient in the center of the papillomacular region on 30,1 % and 11,3 % in comparison with emetropes and with patients with slowly progressive myopia respectively.
Expanded scientific data on changes in the choroid in the rapidly progressive axial myopia, which consists in reducing the thickness of the choroid in the center of the fovea at 21,2 % and in the center of the papillomacular region by 18,3 %, that is accompanied by a decrease in the vascular density index of the layer of choriocapillaries in the nasal sector of macula by 5,4 % compared to emetropes.
For the first time, the effectiveness of using instillations of the synthetic prostaglandin analogue F2-α has been estimated on the model of myopia in the experiment and found, that instillation of latanoprost to the intact rats during the period of intense growth of the eyeball does not affect the rate of age increasement of its sagittal and horizontal size and does not cause changes in the thickness of the choroid of the eye, while instillations of the latanoprost during the simulation of deprivation myopia in rats from 15 to 30 day of life contributes to the reduction of the growth rate of the eyeball and prevent the reduction of the thickness of the choroid, which was observed under the conditions of the modeling of deprivation myopia.
For the first time, the effect of modern regenerative technologies, in particular, the subtenon administration of platelet autocryolysate on the structure of the eye of intact rabbits, has been experimentally studied, and it is proved to contribute to the physiologically ordered formation of collagen fibers, which leads to the strengthening of sclera in rabbits.
Enhanced understanding of possibilities for prostaglandin analogue F2-α administration and new generation cell therapy such as platelet autocryolysate for the treatment of myopia and the feasibility of the new method development for prophylaxis myopia progression by including the instillations of the prostaglandin analogue F2-α and subtenon administration of platelet autocryolysate to the conventional conservative treatment of myopia.
