The dissertation is devoted to the solution of the current task of modern
ophthalmology – increasing the efficiency and optimizing the treatment of age-related
macular degeneration by studying the body’s supply with vitamin D and correcting its
deficiency.
Reasoning of the choice of research topic. Irreversible vision loss is one of the
global problems of humanity. This is not only a medical problem, but also a socio-
economic one, since more money is allocated for the maintenance of incapacitated
people and more material support is needed than for those who can take care of
themselves. AMD ranks third in the world (after cataract and glaucoma) and causes
about 6.6% of the cases of blindness in the developed world, and every year this number continues to grow steadily [1-5]. Wong and colleagues, based on the trend in
the incidence of AMD, calculated that as of 2020, about 196 million people in the
world suffer from AMD, while by 2040, this figure will almost double to 288 million
people [6-7]. Data from a European study show that by 2050 in Europe, 77 million
people will have a diagnosis of AMD, and the frequency of new cases of the disease
will increase by 75% [8]. Evidence shows that people will lose more and more vision
in the future unless ways to prevent or treat macular dystrophy are found.
Age-related macular degeneration is a multifactorial disease: metabolic,
functional, and genetic factors play a role in its pathogenesis. Oxidative stress and
inflammation, which cause irreversible progressive loss of retinal photoreceptors, are
considered one of the main causes of AMD today. Many works devoted to the
pathogenesis of AMD report on immunological aspects as one of the triggering
mechanisms of the development of the disease. According to the classification, AMD
is divided into dry and wet (exudative) form, with the predominance of dry (about
90%) in the incidence of the population [9, 168, 179].
In recent years, many studies devoted to vitamin D determined its role in the
course of chronic inflammatory eye diseases, including AMD [145]. Performing the
functions of both a vitamin and a hormone in the human body, vitamin D takes on a
role in the regulation of calcium-phosphorus metabolism, cell proliferation, and has an
immunomodulatory effect. Its receptors are found in many organs, including the retina
[69-73]. One of the functions of vitamin D is its anti-inflammatory effect [64, 69, 79].
Vitamin D deficiency in women in the postmenopausal period was found among
90% of population of Japan and South Korea, among 75% of the US population and
among 50% of the population of Thailand and Malaysia [198]. Vitamin D deficiency is
widespread in the countries of the Middle East and South Asia, where average levels of
25(OH)D in the blood are at the level of 10-30 nmol/l [210].
In Ukraine, the issue of insufficiency and deficiency of vitamin D also occupies
a leading role among specialists in various fields. According to the research data of
V.V. Povorozniuk et al. (2011), which included 1575 residents of Ukraine aged 20-95,
it was found that 81.8% had vitamin D deficiency, 13.6% had vitamin D insufficiency,
and only 4.6% had an optimal level of vitamin D [105].
