Zakharevych H. Optimization of the diagnosis of the development and progression of microvascular disorders in diabetic retinopathy in patients with type 2 diabetes mellitus

The dissertation is devoted to solving the urgent problem of modern ophthalmology - optimization of diagnostics of development and progression of microvascular disorders in diabetic retinopathy in the presence of type 2 diabetes mellitus on the basis of complex study of clinical and laboratory data, ophthalmological data and vasculoendothelial growth factor type 2 diabetes from the Ukrainian population. Data from 302 patients who went to the clinic for correction of age-related changes in cataract surgery were used. Of these patients, 98 had no CD2T and retinopathy. These individuals were included in the control group. In 204 patients, CD2T with different stages of DR was detected (experimental group). Data on the course of DR were further clarified. It has been shown for the first time that an increase in the level of VEGFA in BP is a key pathogenetic factor in the development of NPDR, and its further increase causes the development of SDA. The presence of a direct and significant effect of VEGFA content in BP and the duration of diabetes on the stage of DR, as well as a significant effect of increasing VEGFA content in BP on the probability of neovascularization of eye tissues, as well as hemophthalmos and SDA. For the first time for patients from the Ukrainian population, it was shown that the rs2010963 polymorphism of the VEGFA gene was associated with DR. Stratification by stages of DR showed that the statistical significance of the distribution of genotypes and alleles rs2010963 had only for patients with SDA. The rs699947 polymorphism was associated with DR. Stratification by DR stages found that the higher frequency of the ancestral C/C homozygote rs699947 was statistically significant only in DDA. The rs699947 polymorphism affected: IPCC, VEGFA BOP levels, and the presence of SDA and hemophthalmos. For the first time it was shown that the indicators "Duration of diabetes", "Sex" and "rs2010963" had a direct, and "Age" and "rs699947" - feedback with the probability of development of both DR and SDA. rate of DR progression from polymorphisms rs2010963 and rs699947 of the VEGFA gene and has a high prognostic ability.