Ophtalmologist priorities in diagnostics and treatment of endocrinous opthtalmopathy

Abstract

Background. Purpose of this research was to evaluate clinical and morphofunctional condition of optic nerve of patients with endocrinous opthtalmopathy and its dynamic on combination treatment analysis. Methods. Was observed 41 patient (76 orbits) with endocrinous opthtalmopathy. Treatment was necessary for patients with mixed type of edematous ophthalmocele and early case of optic neuropathy (15 orbits) and patients with decompensated endocrinous opthtalmopathy (19 orbits). Efficiency of treatment was estimated by the morphofunctional parameters of optic nerve in groups with developed optic neuropathy under myogenic and mixed types of edematous ophthalmocele. Results. Immunosuppressive treatment was efficient on early case and developed stage of compressive optic neuropathy. Functionally under myogenic and mixed types of edematous ophthalmocele acuity of central vision improve in 1.4 times, peripheral vision-in 2 times. Morphofunctional parameters of optic disc significantly changed in process of therapy only under myogenic edematous ophthalmocele. Conclusions. Immunosuppressive therapy of endocrinous opthtalmopathy should began in preclinical phase of process and be initiated by the ophthalmologist. Monitoring of clinical signs insufficient for assessment of the rate of progression and degree of activity of immunopathological inflammation in tissues of orbit. Morphofunctional parameters of visual analyzer based on coherence tomography is the most informative for the control over the efficiency of treatment and prognostication of treatment results. For the detection of the patients with endocrinous opthtalmopathy on subclinical phase more efficient electrophysiological system of diagnostics.