Clinical Diagnostic Criteria of Hypoplasia of the Optic Nerve
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Univer Publishing
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Actuality. Congenital defects of the optic disc are the main risk factor for blindness and vision loss in 5-6% of cases in different countries, and the rate of detection of congenital defects of the optic organ is 2-4%. In turn, genetic changes lead to the development of blindness in children in 50% of cases.
Goals and objectives. The aim of the study is to determine the specific clinical aspects of deprivation in children with congenital defects of the optic disc.
Material and methods. The scientific research work was carried out in 2022-2023 in the city children's clinical hospital №1. During the study, electrophysiological examination and optical coherence tomography were performed in 70 (118 eyes) pediatric patients aged 3 to 18 years with a diagnosis of congenital hypoplasia of the optic disc (Q14.2) and 20 healthy children (40 eyes). the results were analyzed. From the electrophysiological methods of examination, visual evoked potentials (VEP) were conducted on the "Neuron-Spektr 4/VPM" equipment, and the thickness of retinal nerve fibers was evaluated on the optical computer tomography ("Stratus" OST-3 "Carl Zeiss Meditec"). The obtained results were based on the Student's t-criterion. a comprehensive analysis was carried out. The difference between means was considered statistically significant when p≤0.05.
Results and discussion. One-sided decrease in the amplitude of VEP R100 was noted in 75.3% of patients, bilateral decrease in 24.7% of patients. A monocular decrease in amplitude indicated a unilateral prechiasmal level of the lesion, while a bilateral decrease indicated a bilateral disease. As a result of the comparative analysis, it was found that the indicators of visual acuity and retinal nerve fiber thickness (RNFL) thickness are directly related to each other: the lower the total average thickness of RNFL of the injured eye, the lower the visual acuity. A statistically significant reduction in the diameter of the ONH (1.94±0.30 vs. 1.29±0.31 in normal) and physiological expansion (0.32±0.26 in normal vs. 0.65±0.41) was observed in KNG. In accordance with the above, it was observed that their area also decreased.
Conclusions. The importance of optical coherence tomography and electroretinogram in early detection of clinical signs of deprivation has been proven once again in situations where the objective evaluation of the doctor is difficult, when young children cannot give a subjective assessment of their condition with the help of neurophysiological and neurovisual examination methods.
Keywords
electroretinogram, hypoplasia, deprivation, coloboma