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6ISSN 2413-1032
OPTICAL NEUROPATHY WITH EDEMOUS EXOPHTHALMOS
D. m. s. Dolmatova I. А., D. m. s. Stepanova I. S., D. m. s. professor Utelbayeva Z. Т., Berdisheva А. А., Ismailova S. K., Intern of 6-year Shapulatova А. А., Intern of 6-year Yernazarov N. M.
Kazakhstan, Almaty city, KazNMU after S.D.Asfendiyarov
Abstract. Endocrine ophthalmopathy is an eye socket disease that develops on the background of manifestative and hidden dysfunction of the thyroid gland. In the structure of EOP dominates edematous exophthalmos: from 63% to 80% thyrotoxic exophthalmos constitutes 12% - 16% and endocrine myopathy occurs in 8% - 22% cases. Edematous exophthalmos is often considered as an independent nosologic unit. By the clinical duration one differs a corneal form of edematous exophthalmos, optical neuropathy and mixed form. [1,2]
The goal of the work was to study peculiarities of optical neuropathy of patients with edematous exophthalmos. 51 patients with edematous exophthalmos were examined (at the compensation stage - 10, sub-compensation - 29, decompensation - 12) at the age range from 25 to 55 where women prevailed. All patients had a full ophthalmological examination that included a visual examination with a capacity of eye mobility test, exophthalmometry, visemetry, biomicroscopy, ophthalmoscopy, perimetry, noncontact tonometry, examination of the central field of vision, electrophysiological and ultrasound examination andoptical coherent magnetic resonance tomography.
The research results. Ophthalmological changes were registered almost of all conducted patients as dilatation of recline vessels, edema and blurting of edges of the visual nerve disc in 28,7% cases and increase of excavation in 45% cases. The change of the fundus of eye picture was accompanied with a concentric constriction of the sight field (36%), relative and absolute central scotomas (78%). The sight keenness was reduced in 54% cases on average to 0,53±0,04.
Rise of the intraocular pressure of the patients with edematous exophthalmos was registered in 80,4% ccases. The average indices equaled 23,3±1,23 mm Hg; at the subcompensation stage the average value was 24,5±1,2 mm Hg; at the decompensation 27,08±1,75 mm Hg. If the process lasted to one year the intraocular pressure on average equaled 23,1±1,14 mm Hg; to two years it was 25,3±2,2 mm Hg; over three years it was to 26,0±2,15 mm Hg.
The patients with decompensation had increase of the neuro-retinal ring 0,63±0,2; at the norm 0,43±0,02 and to 0,51±0,01 at the stage of в стадии subcompensation, the thickness of the peripapapilar layer of the nerve fibers reliably did not change (94,5±8,1 at the norm 100,7±1,9). The results of USE and MRT registered the increase of volume of both muscles of both orbits of 95% patients; thickening of the sight nerve of 25% patients, volume increase of the retro bulbar tissue was registered in all cases that testified the dysfunction of the venous drainage from the orbit and the sight nerve compression. Thus, optical neuropathy develops as the result of the visual nerve compression by the increased in volume extra ocular muscles and retro bulbar tissue which is accompanied with ophthalmo-hypertension, sight keenness reduction, dysfunction of the central sight field and cases of congestion of the eyeground.
REFERENCES
1. Бровкина А.Ф. Эндокринная офтальмопатия. - М.: Гэотар-Мед,2004. -176с.
2. Behrouzi Z., Rabei H.M., Azizi F., Daftarian N., Mehrabi Y., Ardeshiri M.,Mohammadpour M. Prevalence of open-angle glaucoma, glaucoma suspect, and ocular hypertension in thyroid-related immune orbitopathy.//J. Glaucoma - 2007. - Vol.16,N 4/ - P.358-362.
3. Robert P.Y., Camezind P., Adenis J.P. Complications de l'ophtalmopathie dysthyroidienne. // J.Fr. Ophtalmol. - 2003. - Vol. 27,N 7. - P.819-821.
8 № 3(3), Vol.2, November 2015
WORLD SCIENCE
