Nikolaichuk N. Optimization of treatment tactics of patients with low pressure glaucoma

Українська версія

Thesis for the degree of Candidate of Sciences (CSc)

State registration number

0419U005265

Applicant for

Specialization

  • 14.01.18 - Очні хвороби

12-12-2019

Specialized Academic Board

Д 26.613.05

Shupyk National Medical Academy of Postgraduate Education

Essay

The thesis is devoted to the problem of increasing the efficiency of treatment of patients with low pressure glaucoma in Ukraine using influence of poly- and monochromatic low intensive polarized light on the functional state of visual-nerve apparatus and hydrodynamic of eye. It was supplemented scientific knowledge about possibility of using the method of visualization of retinal ganglionary cells by stereotaxic injections of Fluorogold 2% (FG, Termofisher of scientific) with further identification with help of fluorescent microscopy. Method is highly specific and can be used for quantitative analysis and study of their damage degree in glaucoma in the experiment on enimals. It was established positive influence on saving of greater amount of ganglionary cells in retina tissue with monochromatic low intensive polarized green light therapy (563nm) at power density of 40 mW/cm2, light energy per minute 2,4 joule/cm2, working distance of 30 cm, exposure 3 minutes within 10 days (1 session per day) both in control (increased by 13,9%, р<0,05) and in the experimental model of low pressure glaucoma in rats (increased by 26,6%, р<0,05). The scientific information has been supplemented with positive influence of application of courses of monochromatic low intensive polarized green light (563 nм) at power density of 40 mW/cm2, light energy per minute 2,4 joule/ cm2, working distance of 30 cm, exposure 3 minutes within 10 days (1 session per day) in combination with local pharmacotherapy with 2% cyticolin as the method of neuroprotective treatment of patients with low pressure glaucoma, and also as a prophylaxis of hydrodynamics disturbance and improvement of visual functions of eye for the healthy persons. It was noted the improvement of index of MD to a 38,6% (р<0,05), index of PSD to 30,8% (р<0,05), increase of peak amplitude of electroretinogram by means 22,2% (р<0,05) at the glaucoma of low preasure of I stage and to 41,3% (р<0,05) with glaucoma of II stage, decrease in the latency of the peaks of complexes ICPE to 11,2% (р<0,05) at glaucoma of I stage and to 16,2% (р<0,05) at glaucoma of II stage; increasing of the amplitude of peaks of pattern ERG to 15,9% (р<0,05) at the glaucoma of low preasure of I stage and to 19,2% (р<0,05) at glaucoma of II stage, decreaseing of index of the latency of the peaks of complexes of pattern ERG to 14,1% (р<0,05) at the glaucoma of low preasure of I stage and to 14,4% (р<0,05) at the glaucoma of low preasure of II stage, Norna test increased to 34,6% (р<0,05); Schirmer test increased to 74,7% (р<0,05), Lipkof test decreased to 66,9% (р<0,05), fluorescein test decreased to 72,5% (р<0,05), OPI test increased to 45,3% (р<0,05). The use of PILER light therapy as an additional method of conservative treatment of patients with low pressure glaucoma will expand the scope of medical care and enhance the effectiveness of other methods of drug treatment for this disease, reduce the level of disability in the group of eye diseases and solve an important scientific applied problem of modern ophthalmology.

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