Object. Diabetic retinopathy, rhegmatogenous retinal detachment, secondary neovascular glaucoma. Purpose. To develop a new system for diagnosis and monitoring of treatment of patients with vascular and degenerative ophthalmopathology (diabetic retinopathy, secondary neovascular glaucoma, rhegmatogenous retinal detachment) by using data on heat transfer (temperature and heat flux) of healthy eye and eye with pathology based on the study of biophysical, structural, ultrastructural and clinical parameters of the eye in the experiment and clinic. Methods. Biomicroscopy, ophthalmoscopy, epibulbar and intraocular thermometry, rectal thermometry, epibulbar heat flux measurement, light microscopy of the chorioretinal complex, electron microscopy of the chorioretinal complex were performed in the experimental study. Visometry, tonometry, ophthalmoscopy, color photography of the anterior segment of the eye and fundus, optical coherence tomography, rheophthalmography, epibulbar temperature and heat flux measurement, infrared thermography were performed in the clinical study. Statistical analysis was performed using the software package Statistica 10.0. Scientific novelty. For the first time, the heat flux density from the surface of the cornea was detected and its dependence on human age was established. The ocular heat flux density of the healthy human aged 18-30 years averaged 8,6 ± 1,2 mW/cm2; 31-60 years – 7,4 ± 1,1 mW/cm2; older than 60 years – 7,0 ± 1,0 mW/cm2. For the first time, it was established that the heat flux density from the surface of the cornea varies depending on the state of the choroidal blood supply. For the first time, it was established that with the progression of diabetic retinopathy, the heat flux density of the eye on the surface of the cornea decreases, but the temperature of the cornea remains unchanged. Thus, the heat flux density from the surface of the eyes with a non-proliferative diabetic retinopathy (7,3 ± 2,1 mW/cm2) was higher compared to the proliferative diabetic retinopathy (6,3 ± 1,6 mW/cm2). There were no significant differences in corneal temperature in patients with nonproliferative (34,7 ± 1,3° C) and proliferative (34,8 ± 1,1° C) diabetic retinopathy. For the first time, it was proven that an increase in intraocular pressure causes a decrease in heat release from the surface of the eye. For the first time, it was established that during vitrectomy with irrigation fluid of room temperature (24,2° C) in patients with rhegmatogenous retinal detachment and patients with proliferative diabetic retinopathy there is an uncontrolled intraoperative hypothermia of intraocular structures with the subsequent rapid increase of intraocular temperature (on average by 0,3° C per minute), and in 25 % of patients there is an increase of epibulbar temperature and heat flux density of the operated eye in the postoperative period. Practical value. A thermoelectric device for measurements of intraocular temperature and a thermoelectric measuring probe with a low thermal conductivity were developed. A thermoelectric device for real-time registration of the heat flux density of the outer surface of the eye was developed. A mathematical model of thermal processes of the rabbit eye was created taking into account its anatomical, thermophysical, hemodynamic features, temperature distribution and heat fluxes. A method of intraoperative monitoring of intraocular temperature was developed. A system of diagnosis and monitoring of treatment of patients with vascular and degenerative eye diseases (diabetic retinopathy, secondary neovascular glaucoma, rhegmatogenous retinal detachment) was developed based on the study of eye heat exchange using ocular temperature and heat flux density measurement data. The results of the work were introduced into the clinical practice of the Department of studying biological action and application of lasers in ophthalmology and the Department of vitreoretinal and laser surgery of the State institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine”, Odesa; surgical department № 2 of the municipal institution "Starobilsk District Territorial Medical Association", Starobilsk; clinical highly specialized center of eye microsurgery with a block of eye trauma and acute pathology of the visual organs of the Municipal non-profit company "The Pirogov Vinnytsia Regional Clinical Hospital of the Vinnytsia Regional Council", Vinnytsia. Scope. Medicine, ophthalmology.
