N 5 (177) 2021. P. 40–47

THE NATURE OF CHANGES IN THE HEMODYNAMICS OF THE EYES OF PATIENTS WITH CHRONIC ANTERIOR IDIOPATHIC UVEITIS COMPLICATED BY OPTIC NEURITIS WITH TRANSITION TO ATROPHY

O. V. Kovtun, L. V. Venger, N. І. Khramenko

Odesa National Medical University MH of Ukraine, Odesa, Ukraine
SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine”, Odesa, Ukraine

DOI 10.54229/2226-2008-2021-5-8

Aim. To determine the nature and direction of changes in the hemodynamics of the eyes of patients with chronic anterior idiopathic uveitis complicated by optic neuritis with transition to atrophy.

Materials and methods. The study involved 18 people with chronic anterior idiopathic uveitis complicated by optic neuritis with transition to atrophy. Ophthalmological (ophthalmoscopy, biomicroscopy, intraocular pressure, perimetry, visual acuity with maximum correction) and electrophysiological (volumetric pulse blood filling, vascular tone of the eye, volumetric blood flow rate) studies were performed before and after treatment for a year. The treatment was carried out according to the protocol: at the first visit — non-steroidal anti-inflammatory drugs, antibiotics, immunosuppressant, corticosteroids and immunomodulatory; with subsequent metabolic and vitamin therapy, physiotherapy. Statistical analysis was performed using Statistic 12.0 software. The t-test of Student and Wilcoxon was used.

Research results. As a result of treatment, the visual functions of patients improved: the number of people with higher visual acuity is increasing. In the period up to 6 months after treatment, the number of patients with low visual acuity (0.12–0.5) decreased from 94.4 to 50%; in 11 of 13 visual acuity increased to 0.3–0.5 (66.7% of all subjects). A year after the treatment, the visual acuity in the diseased eyes remained the same. The study of eye hemodynamics showed a significant (p<0.000) increase in all parameters in the diseased eye relative to the healthy one before treatment: volumetric pulse blood filling — by 64.8; the tone of large eye vessels — by 10.1, small — by 17.5; the rate of volumetric pulse blood filling — by 37.8%. Comparative analysis of the hemodynamic data of sick eyes at different periods after treatment revealed a significant decrease in volumetric pulse blood filling to 66.4 and 52.4%, the rate of volumetric pulse blood filling to 60.2 and 44.4%. A decrease in the tone of large vessels by 3.1 and 6.4%, and small — up to 94.6 and 92.7% at the time of up to six months and up to a year relative to the initial data (p<0.000 in all cases).

Conclusions

  1. As a result of treatment, the visual functions in the diseased eye improve without deteriorating until a year after treatment.
  2. Before treatment, hemodynamic indices are increased (p<0.000) in the diseased eye relative to the healthy one.
  3. Six and 12 months after treatment, the volumetric pulse blood filling, the rate of volumetric pulse blood filling, the tone of large and small vessels were significantly reduced relative to the initial data.

Key words: chronic anterior idiopathic uveitis, optic neuritis, optic atrophy, treatment, eye hemodynamics.

 

References

  1. Glants S. Medical-biological statistics. Moscow. Praktika, 1998. 459 p. (In Russian)
  2. Moiseenko RO, Golubchikov MV, Rykov SO. Ophtalmologic aid in Ukraine within the years of Independence. Analytic stat. guide. Kropivnytskyi. Podium, 2019. (In Ukrainian)
  3. Nikolaienko MM. Peculiarities of changes of proinflammatory and anti-inflammatory cytikines and gelatinase B with uveitis complicated by injuries of the visual nerve. Abstract of cand of med. Sciences. 14.01.18. Kyiv, 2020: 23. (In Ukrainian)
  4. Bennett JL. Optic Neuritis HHS. Minneapolis, Continuum, 2019: 1236-1264. DOI: 10.1212/CON.0000000000000768.
  5. Bragazzi NL et al. Public health awareness of autoimmune diseases after the death of a celebrity. Clin. Rheumatol. 2017. https://doi.org/10.1007/s10067-016-3513-5.
  6. Harthan JS, Opitz DL, Fromstein SR, Morettin CE. Diagnosis and treatment of anterior uveitis: optometric management. Clin. Optom. (Auckl). 2016;8:23-35. doi: 10.2147/OPTO.S72079 PMCID: PMC6095364 PMID: 30214346
  7. Huang JJ, Gau PA. Ocular inflammatory disease and uveitis manual diagnosis and treatment. Philadelphia, Lippincott Williams & Wilkins, 2010:1-9.
  8. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature (SUN) working group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am. J. Ophthalmol. 2005;140(3):509-516. https:// DOI: 10.1016/j.ajo.2005.03.057.PMID: 16196117.
  9. Kovtun AV, Vеngеr LV, Khrаmеnkо NI. Possibility of early diagnosis of complications of optic neuritis in patients with anterior uveitis according to cogerent tomography of the eye orbit : RAD Conference Proceedings. 2020;4:109-12. ISSN 2466-4626 (online). DOI: 10.21175/RadProc.2020.23 www.rad-proceedings.org
  10. Neuroprotective agents in the management of glaucoma / Nucci C. et al. Eye (Lond.). 2018;32(5):938-45.
  11. Peli E, Satgunam P. Bitemporal hemianopia; its unique binocular complexities and a novel remedy. Ophthalmic Physiol. Opt. 2014;34(2): 233-42. https://doi.org/10.1111/opo.12118 PMID:24588535).
  12. Sena DF, Lindsley K. Neuroprotection for treatment of glaucoma in adults. Cochrane Data base Syst. Rev. 2017;1. CD006539. https://doi. org/10. 1002/14651858. CD006539. pub4.
  13. Snell RS, Lemp MA. The eyeball. Clinical anatomy of the eye. 2nd ed. Malden, MA, Blackwell Science, 1998:140-56.
  14. Susanna FN, Pavesio C. Review of ocular adverse events of biological anti-TNF drugs J. of Ophthalmic Inflammation and Infection 2020;10:11 https://doi.org/10.1186/s12348-020-00202-6A.
View article PDF