The thesis deals with the development of a new algorithm for the diagnosis of the state of the lamina cribrosa and morphological changes of the optic nerve disc with the help of optical coherent tomography in patients with myopia and experimental medication strengthening of the sclera and lamina cribrosa in experimental animals by instillations of low doses of atropine sulfate. Myopia is the most common visual defect. Complicated myopia is one of the main causes of disability due to eye diseases. In the case of myopia, the axial length increases, and all shells are loosened. Especially changes lamina cribrosa (LC). Clinical evaluation of the parameters of LC is obviously of high diagnostic significance. The relation between the deformity of the optic nerve disc and the deformation of the LC and its pores remains unknown. It is known only that the severity of the lesion will depend on the degree of damage to the nerve and ganglion fibers and the degree of change in the structure of the lamina cribrosa. There is a modern method of stabilizing myopia due to low doses of atropine sulfate. The biochemical basis of how atropine inhibits the extension of the axial length of the eyeball remains unclear. Studies of morphological changes in the lamina cribrosa using optical coherence tomography were performed in patients with low, medium, high degree myopia, and in the control group. The following parameters were calculated: length from one edge of the Bruch membrane to the other, maximum depth of the LC, insertion depth of the LC, length from one edge of the LC to the other. The following results were obtained: 1) The study of the indicators of the LC revealed reliable differences between the data of groups I and II in comparison with the values of the control group (group IV). There are also reliable differences between the values of indicators of groups I, II, and III. 2) The length from one edge of the Bruch membrane to the other in the control group was (1.71 ± 0.08) mm. In groups of patients with high and medium degrees of myopia, the results of the indicator differ by almost 25% and 14%, respectively. 3) Indicators of maximum depth of positioning of LC in groups I and II are higher than those of the control group by 47% and 28%. 4) The values of the insertion depth of the LC and the median depth of the LC in patients with myopia are also higher than those of the control group. The values of these indicators in Group I and II are almost 1.5 and 1.3 times higher than in the control group. Significant differences were found in all indicators of the optic nerve disc from 20 to 40% between all degrees of myopia compared with the normal group. Observation shave shown that focal loss of ganglion cell complex (FLV) and global retinal ganglion cell volume (GLV) loss have been particularly pronounced. The most significant is an increase in Nerve Head by 1.6 times in accordance with the norm, a decrease in the values of Optic disc area by 1.4 times. There was a 2.8-fold increase in global retinal ganglion cell complex (GLV) volume loss and a 5.3-fold increase in focal ganglion cell complex (FLV) volume. For the prevention of dystrophic consequences of myopia, patients were treated with a vitamin complex containing carotenoids, omega-3 fatty acids, lutein, zeaxanthin, and a complex of B vitamins. In order to determine the effectiveness of the proposed comprehensive treatment, all patients with mid- and high-grade myopia were divided into 2 subgroups. The study revealed a tendency to improve visual acuity, lack of significant changes in AES, IOP of the eye, mean refraction in the main group of patients throughout the treatment period, improving the perimeter of Humphrey MD and PSD. During the experiment аnimals (rabbits) were administered with atropine instillation at a concentration of 0.5% and 0.01% once daily throughout the experiment. Studying the effect of small doses of atropine sulfate on the sclera, lamina cribrosa and retina, a significant increase in the thickness of the sclera, lamina cribrosa and its pores was found in both groups compared to the group of intact animals due to stimulation of synthetic fibroblast activity. Signs of stimulation of collagenogenesis are revealed also. Further researches of influence of 0.01% solution of atropine sulfate on sclera and LC are appropriate on patients with myopia. The marker method allows to study the morphology of the lamina cribrosa in 75-94.4% of cases. Due to stabilization of visual field sensitivity in patients of the studied groups we can recommend nutraceuticals as a preventive therapy for myopia..
