Диагностика патологии зрительного нерва (ЗН) основывается на результатах клинико-инструментального обследования, электрофизиологического исследования, компьютерной томографии (КТ) и магнитно-резонансной томографии (МРТ). Возможности этих методов нередко ограниченны, а стоимость высока. Ультразвуковое исследование является неинвазивным, высокоинформативным и относительно недорогим методом. Обзор посвящен роли эхографии в дифференциальной диагностике заболеваний ЗН, представлены сведения о технике измерения диаметра ЗН и его нормативных параметрах. Помимо офтальмопатологии, В-сканирование ЗН является необходимым диагностическим методом при заболеваниях головного мозга и системной патологии. В клинической практике для оценки степени тяжести поражения и эффективности лечения заболеваний ЗН огромное значение имеет определение его основных акустических и биометрических характеристик. Требуется дальнейшее изучение сопоставимости результатов измерения интраокулярной и ретробульбарной частей ЗН с использованием различных методов визуализации. Ключевые слова: ультразвуковое исследование; В-сканирование; диаметр зрительного нерва; компьютерная томография; магнитно-резонансная томография Конфликт интересов: отсутствует. Прозрачность финансовой деятельности: никто из авторов не имеет финансовой заинтересованности в представленных материалах или методах.

Purpose: to study the correlation between the acoustic and morphometric parameters of the optic nerve (ON) and anthropometric data in healthy young people.Material and methods. The research involved 24 healthy volunteers (48 eyes), including 9 men and 15 women, the average age was 25.0 ± 1.9 years. Anthropometry included measurements of height, weight, and body mass index (BMI). Ultrasound examination of the retrobulbar part of the ON included measurement of the thickness of the ON with and without sheath, echodensitometry of the ON, and ocular biometry. Using optical coherence tomography, we measured the intraocular part of the ON, including the registration of Bruch's membrane opening and ovality index.Results. The average ON thickness with the sheath was 4.6 ± 0.3 mm, and without sheath, 2.6 ± 0.2 mm. In men, ON with the sheath was thicker than in women (p = 0.001). The acoustic density of the parenchyma of the orbital part of ON was 101.2 ± 11.4 r.u. in women, the mean acoustic density of the ON was significantly higher than that in men. Correlation analysis revealed a statistically significant correlation between the height and the thickness of the ON with the sheath (r = 0.480). The strongest reliable correlation was established between the index of the ON thickness and body weight (r = 0.712) and BMI (r = 0.509) (p < 0.05). No statistically significant correlation was found between the morphometric parameters of the optic disc, anthropometry data and acoustic parameters of the ON.Conclusion. Studying the acoustic and morphometric characteristics of the intraocular and intraorbital parts of the ON in healthy young people, which included anthropometric data and gender characteristics, will contribute to the development more accurate diagnostic criteria of ON state evaluations.

The experience of diagnosis and surgical treatment of spine osteoid osteoma and osteoblastoma in 60 patients was presented. In 78% of cases osteoid osteoma was diagnosed before operation, in 36% of cases by X-ray examination, and in 86 % of all patients examined by CT method. Osteoblastoma was diagnosed by clinical examination in 8% of cases, and by CT method in 80% of the examined patients. By morphologic criteria noninvasive osteoblastoma (osteoid osteoma) 33 observations, invasive one 23 observations, malignant (agressive) 2 observations, multifocal one 2 observations were differentiated. The conclusion was drawn that there were various types of single pathologic process, i.e. osteoblastoma. Surgical treatment tumor resection together with surrounding zone of sclerosis, gave the recovery in 95% of cases. Three patients with tumor recurrence refused reoperation, their outcomes were unknown.

Purpose: to develop objective acoustic criteria of the condition of the optic nerve and its sheaths for an early diagnosis of intracranial hypertension (IH). Material and methods. The research involved 24 patients (average age 35.8 ± 8.5 years) with suspected IH. The control group consisted of 48 healthy subjects (average age 28.5 ± 9.5 years). Ultrasound examination of the retrobulbar part of the optic nerve (ON) included the measurement of the ON thickness with sheaths (ONSD) and without sheaths (OND) and the calculation of the ratio K = ONSD/ OND. Echodensitometry was used to evaluate the echographic density of the parenchyma and the sheaths of the optic nerve. All patients were tested with magnetic resonance imaging (MRI) to analyse brain images. Results. The biometrical parameters of ON in healthy subjects were as follows: ONS 2.64 ± 0.21 mm and ONSD — 4.60 ± 0.34 mm. In patients with suspected IH the average parameters of the ON diameter were as follows: ONS — 2.57 ± 0.25 mm and ONSD — 5.81 ± 0.42 mm. A comparative assessment of the ON thickness with and without sheaths showed that in the control group the values of ONS did not exceed 3.5 mm and ONSD did not exceed 5.0 mm. In patients with IH, the values of ONSD were significantly higher than those in the control group (p < 0.05). The ratio coefficient (K)=ONSD/ONS in the group of healthy subjects ranged from 1.53 to 2.0 and averaged 1.75 ± 0.14. In patients with IH the values of K exceeded 2.0 (2,40 ± 0.18). The analysis of acoustic density data showed a significant variability in the parameters of the ON sheaths echodensitometry in IH patients as compared to the norm. Conclusion. The echography of the ON makes it possible to determine the acoustic and biometric parameters of the ON with high accuracy, to assess its structure and relationship with the surrounding tissues. The ratio coefficient (K) of ONSD/ONS makes it possible to determine IH in the early stages of the disease, even in the absence of objective clinical criteria.

Purpose: to determine objective echographic criteria for the differential diagnosis of anterior ischemic optic neuropathy (AION) and optic neuritis (ON).Material and methods. The research involved 60 patients aged 40 to 60 years, including 30 patients with suspected AION and 30 patients with suspected ON. The control group consisted of 40 healthy volunteers. In addition to the standard ophthalmological examination, all patients underwent ultrasound optic nerve s examination with measurement of the optic nerve thickness and acoustic density (AD) of the parenchyma and optic nerve sheets. Assessment of blood flow in retrobulbar vessels was carried out in the modes of Color Doppler Imaging and pulse dopplerography.Results. There were no statistically significant differences in average echographic parameters of the optic nerve s thickness between the groups of patients with AION and ON. In patients with ON there was a statistically significant decrease in the average AD index compared to that in patients with AION and in healthy volunteers (106.02 ± 5.40 y. e., 146.58 ± 9.70 y.e. and 135.3 ± 2.1 y. e., accordingly). The AD values in all patients with AION exceeded 133 y. e., in patients with ON this index was less than 132 y. e. Evaluation of hemodynamic parameters in the vessels of the eye demonstrated a statistically significant decrease in the peak systolic velocity (Vsyst) and end-diastolic velocity (Vdiast) blood flow in the central retinal artery and medial and lateral short posterior ciliary arteries in patients with AION (in 2-fold) compared with ON and normal indices (p < 0.001). There were no statistically significant differences between parameters of blood flow in patients with ON and in healthy volunteers. In addition, there were no significant intergroup differences of hemodynamic parameters of the ophthalmic artery (p > 0.05).Conclusions. AD of the optic nerve and parameters of blood flow velocities (Vsyst and Vdiast) in medial and lateral short posterior ciliary arteries can be attributed to the diagnostic criteria of the AION and ON.