Transpalpebral Rheoophthalmography as a Method for Evaluating the Effectiveness of Sclera-Strengthening and Trophic Treatment of Progressive Myopia

Abstract

Purpose:to evaluate, using transpalpebral rheoophthalmography (TP ROG), the effectiveness of sclera-strengthening and trophic treatment of progressive myopia with a new biologically active chitosan-containing transplant.Patients and methods. 40 children and adolescents with moderate or high progressive myopia, averagely aged 12.6 ± 0.38 years, were examined after receiving low invasive sclera-strengthening surgery on one eye with a biologically active chitosan-containing transplant. The initial refraction of the operated eye was — 6.25 ± 0.23 D, while that of the fellow eye was — 5.85 ± 0.28 D. The yearly gradient of myopia progression averaged 1.10 ± 0.04 D. Hemodynamic parameters were measured using TP ROG) prior to intervention, then 1, 6 and 12 months after intervention. At the same time points, scleral acoustic density (SAD) was determined by analyzing tissue histograms obtained with a multipurpose ultrasound device, VOLUSON 730 Pro «GE».Results. One year after sclera-strengthening treatment, a 4.4-fold reduction of myopia progression rate on the operated eye was noted, supplemented by a 2.2-fold reduction of same on the fellow eye. Stabilization of refraction was accompanied by an increase of SAD: 6 months after the surgery, SAD was averagely 19.7 conventional units higher than the original figure in the posterior pole of the operated eye, and 16.2 conventional units higher in the equatorial area. One year after the surgery, the figures were, respectively, 15.9 (p < 0.05) and 14.0 conventional units (p < 0.01). The rheographic index of TP ROG increased with regard to the initial value by 139 % after one month, by 69.8 % after 6 months, and by 34.6 % after 1 year. On fellow eyes, the index also tended to increase: by 123.3 % after 1 month, by 65.2 after 6 months, and by the end of the follow-up period it exceeded the original value by 28.7 %, which is an evidence of a pronounced trophic effect of sclera-strengthening myopia treatment with chitosan not only on the operated eye but also (to a lesser extent) on the fellow eye.Conclusion. TP ROG is an effective evaluation method of sclera-strengthening treatment of progressive myopia. This method can also be used to study eye hemodynamics in a variety of ophthalmic pathologies, including those managed in pediatric clinical practice.

Current assessment results of the efficacy and safety of scleroplasty in progressive myopia

“…После такого лечения у детей и подростков с прогрессирующей миопией средней и высокой степени установлено существенное снижение ГГП (в 4,4 раза) и удлинения ПЗО, достоверное повышение акустической плотности склеры, аккомодационного ответа, интраокулярного кровотока и толщины хориоидеи, что свидетельствует о значительном трофическом и гемодинамическом эффекте предложенного БАТ на оболочки миопического глаза. Улучшение регионарной гемодинамики привело к снижению ГГП и на парном, неоперированном глазу в 2,2 раза [86,87].…”