The dissertation is devoted to the problem of increasing the efficiency of diagnosis, prognostication and treatment the patients with atrophy of the optic nerve of different etiologies by determining the diagnostic significance of morphofunctional indicators of optic nerve and retina, as well as the coefficients of their correlation in the Ukrainian population. The optic nerve is the main cause of weakness and blindness, so studying this problem is an important issue in clinical and social ophthalmology. Scientific novelty of the results. Supplemented scientific knowledge about the distribution of optiv nerve atrophy (ONA). Its frequency in the structure of eye diseases was 2.1%, and in 86% of cases there was a bilateral localization of the pathological process. Patients with AION in 47.8% had IV degree atrophy of the optic nerve, 13.0% - V degree, when the changes in the optic nerve were irreversible. The scientific data on electrophysiological indices of the retina and optic nerve have been refined. It has been established that the threshold of electrical sensitivity for phosphene (TESP) at partial ONA V stage is not determined, while at stage IV it is statistically significant (p <0,05) higher by 118% compared with stage I.
Supplemented scientific knowledge about the peculiarities of changes in the field of view at partial ONA of different etiologies according to Humphrey perimetry data. The overall light sensitivity of the central field of view at the partial ONA of the vascular genesis was statistically significant (p <0,05) lower by 26%, the total sensitivity of the peripheral field of vision was 42%, MD by 78%, while the PSD index was higher by 133% , with partial ONA of inflammatory genesis, the overall light sensitivity of the peripheral field of vision is lower by 25%, MD by 74%, with ONA of the central genesis, the MD index is lower by 62% compared with the control group. The scientific data on morphofunctional changes of optiv nerve and retina at partial ONA of different etiologies are specified. The RNFL thickness, and Average GCL + IPL for ONA vascular genesis was statistically significant (p <0,05) lower by 35%, with ONA inflammatory genesis RNFL thickness lower by 31%, the Average GCL + IPL is lower by 34%, at ONA the central genesis is lower by 31% and 33% respectively, in comparison with the control group. It was found that in the V stage of ONA of different etiology, the ratio of MD / RNFL thickness to 44% was statistically significant (p <0,05), the MD / Average GCL + IPL ratio was reduced by 39% compared with stage I, and with an increase in the coefficient MD / RNFL thickness by 46% and MD / Average GCL + IPL by 48%, statistically significantly increased visual acuity (p <0,05). For the first time, the mathematical models of prediction of low (<0.3) visual acuity were developed for the estimation of the severity of the ONA course in different etiologies and the effectiveness of the new treatment methods. The sensitivity of the test is 100% (95% CI 82.4% - 100%), the specificity of the test is 93.1% (95% CI 77.2% - 99.2%) according to the indicator of PES, when choosing a critical threshold > 265 mcА. By the factor MD/RNFL thickness, the criticality threshold of <= -0,036 is 95.2% (95% CI 76.2% -99.9%), the specificity of the test is 96.6% (95% CI 82, 2% - 99.9%). By the indicator MD/Average GCL + IPL thickness, with a critical threshold of <= -0.059 the sensitivity of the test is 100% (95% CI 83.9% - 100%), the specificity of the test is 93.1% (95% CI 77.2 % - 99.2%). The mathematical models of prediction of the heavy stage of the ONA are developed. By the factor MD / RNFL thickness, with a critical threshold of <= -0,043, the sensitivity of the test is 100% (95% CI 66.4% - 100%), the specificity of the test is 100% (95% CI 91.4% - 100%). By the indicator MD Average GCL + IPL thickness, with a critical threshold of <= -0.059 the sensitivity of the test is 100% (95% CI 66.4% -100%), the specificity of the test is 65.9% (95% CI 49.4 % - 79.9%). The practical value of the results obtained. A new standardized clinical classification has been developed by which, in the distribution of patients with partial ONA of different etiology, it is established that regardless of the degree of atrophy, in 48,6% there is a significant defeat of the fibers of the papillomacular bundle, and a low visual acuity, with 29,8% of visual acuity remains high.
