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Kurbanazarov Muratbai Kunnazarovich, Head of the Surgical Diseases Department of the Nukus Branch of the Tashkent Pediatric Medical Institute
Abdullaeva Nuria Zhalgasovna, assistant, of the Department of Surgical Diseases of the Nukus Branch
of the Tashkent Pediatric Medical Institute Palekeeva Gulzhakhan Parahatovna, assistant, of the Department of Surgical Diseases of the Nukus Branch
of the Tashkent Pediatric Medical Institute E-mail: evovision@bk.ru
EVALUATION OF THE STATE OF EXTRA-SCOPE PATHOLOGY AT CHILDHOOD IN CHILDREN IN THE SOUTHERN REGION OF ARAL
Abstract: In parallel with the deterioration of the ecological situation, there were high rates of registration of morbidity in the South Priaralye region. Risk factors that determine the changes in the functional state of the human body are singled out, which reduces its stability, depletes the protective forces, strengthens the pre-pathological conditions, and exacerbates infectious processes. In the region with increased influence of environmental and climatic factors, high rates of extracardicular pathology in children with myopia are noted.
Keywords: Priaralye, ecology, myopia in children and adolescents, concomitant diseases.
Despite numerous studies, myopia remains one of In this regard, the opinion was expressed that the in-
the most common pathologies in ophthalmology. The fluence of many unfavorable factors is mediated through
data of the scientific literature shows that the frequency the accommodation apparatus. Factors contributing to
of occurrence of myopia in children and adolescents in the development of myopia and its progression in more
different countries ranges from 20-30 to 60-80% of the than 70% of cases is the weakness of accommodation
total incidence. Myopia suffers from 28.4 to 35% of the [6, 7].
world's population, of which high-grade myopia is noted Objective: to study the presence and frequency of
in 4-9% [1, 5, 8]. On the other hand, the territory of the concomitant pathology in children with myopia in cer-
southern Aral Sea is recognized as an ecologically unfa- tain regions of the Southern Aral region. vorable region, in connection with the deterioration of Material and methods of the study: ophthalmic
the quality of drinking water, pollution of atmospheric status 52 (congenital form 11, acquired-41) of sick chil-
air and soil, high incidence rates in the South Priaralye dren aged 1-18 years old (Nukus, Khodjeyli, Kanlykul,
region have been registered in parallel [2, 4, 6, 7, 8]. Risk Shumanay, Kegeili) and 50 patients (congenital-12, ac-
factors that determine the changes in the functional state quired-38) of the same age of the northern (Chimbay,
of the human body are singled out, which reduces its sta- Karauzyak, Takhtakupir) regions of the southern Aral
bility, depletes the protective forces, strengthens the pre- Sea region. The territory of the Republic of Karakal-
pathological states, and exacerbates infectious processes pakstan due to the impact of environmental factors and
[2, 6, 7]. The data of the literature testify that with pro- socio-economic conditions is divided into the coastal,
longed observation of children with myopic refraction, northern, central and southern zones, in connection with
it was possible to trace a clear connection between the which the studies were carried out on the zones of the
presence of common diseases and the deterioration of region [3]. According to the data of the SGS, in the last 5
the state of the accommodative apparatus [1, 7, 8]. years, the pollution of drinking water in 33.7%, pollution
EVALUATION OF THE STATE OF EXTRA-SCOPE PATHOLOGY AT CHILDHOOD IN CHILDREN IN THE SOUTHERN REGION OF ARAL
of air in 41.4% of samples in the northern zone, which are 7.8% and 24.6% in the central zone. Ophthalmic examinations, such as vidiometry, refractometry, ophthalmoscopy and outpatient card data for the development of the child f-112-y have been carried out. Statistical processing was carried out under the EXCEL program.
Results of the study: Central zone. Concomitant diseases are an unfavorable background, affecting the development and clinical course of myopia. The percentage of healthy children with acquired nearsightedness was 23.8 (10 patients), the main part of which suffer from concomitant diseases: iron deficiency anemia 11 (26.1%), upper respiratory tract pathology 7 (16.6%), infectious hepatitis 5 (11.9%), hypothyroidism 5 (11.9%), pathology of the genitourinary system 4 (9.5%). While 3 (27.2%) healthy children were observed with congenital myopia, and among the concomitant diseases, iron deficiency anemia 3 (27.2%), congenital anomalies 3 (27.2%), with pathology of the upper of the respiratory tract 1 (9.0) of the patient and also one patient (9.0%) suffered an infectious hepatitis in the anamnesis. Anisometropia up to 3.0 AD was detected with acquired myopia in 7 eyes (8.4%) and with congenital myopia in 2 eyes (9.0%), anisometropia more than 3.0 Dpt. with near-term myopia diagnosed on 2 eyes (2.4%) and congenital also in 2 eyes (9.0%).
Thus, with acquired myopia, astigmatism was observed in 25.3% of cases (21 eyes), while in congenital myopia 36.3% (8 eyes), anisometropia with acquired near-sight was detected in 10.8% of cases (9 eyes) and with congenital myopia in 22.7% of cases (5 eyes). Astigmatism with congenital myopia was observed more often than with acquired myopia: up to 2.0 doses 1.2 times more often (18.1%), up to 3.0 d in 1.6 times (13.6%) and more than 5.0 D. 1.8 times (4.5%). The magnitude of anisometropia to 3.0 D. in congenital myopia is 1.0 times greater (9.0%), more than 3.0 times 3.7 times more often (9.0%) than with acquired nearsightedness.
Northern zone. It is important to note that only one child is identified that does not suffer from concomitant pathology, and in most children with acquired form of myopia an extraocular pathology is observed: iron deficiency anemia in 12 (31.5%) patients, bronchitis in 8 (21.0%) children, hepatitis in 7 (18.4%), 5 (13.1%) patients had nephritis and 5 (13.1%) hypothyroidism. While with congenital myopia, all children had concomitant diseases, among them 5 (35.7%) patients had iron deficiency anemia, congenital anomalies in 4 (28.5%) patients. In 2 children (14.2%), bronchitis and infectious hepatitis were detected, in 1 patient (7.1%) the patient had endemic goiter.
Thus, in the region with high rates of air and drinking water pollution extraocular pathology is noted more often than with lower indicators of environmental pollution. With the acquired myopia, astigmatism was observed in 43.2% of cases, while in congenital myopia 60.7% was 1.4 times greater, anisometropia with acquired near-sight was detected in 14.8% ofcases (11 eyes) and in 1.7 times more often with congenital myopia in 25.0% of cases (7 eyes). Astigmatism was more often observed with congenital myopia, up to 2.0 doses 1.3 times more often (32.1%), up to 3.0 D in 1.7 times (21.4%) and more than 5.0 doses in 1, 7 times (7.1%). The magnitude of anisometropia to 3.0 D. in congenital myopia is 1.3 times greater (14.2%), more than 3.0 times 1.9 times more often (10.7%) than with acquired nearsightedness.
Conclusions: 1) a correlation between the presence of myopia and extraocular pathology in children was revealed; 2) there are high rates of myopia with a predominance of astigmatism and anisometropia in the zone where there is a deterioration in the ecological situation; 3) a higher incidence of extraocular pathology in children with myopia in an ecologically unfavorable region was detected; 4) it is necessary to develop preventive measures depending on the state of the environment.
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