https://doi.org/10.30702/Ophthalmology28122021-15.4.41-51/17-085.8
UDC 617.713-007.17-085.85

Iryna V. Shargorodska, Olha S. Sas

Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

Abstract. Introduction. Degenerative-dystrophic changes of the cornea (H16.2; H18.3-18.5) affect millions of people worldwide and are common ophthalmic diseases. In the United States, this pathology affects about 2 million patients aged over 50. Prevalence rate varies from about 10 to 30% of the total population. A similar trend is observed in Ukraine.

Pathogenesis of degenerative-dystrophic changes of the cornea involves a defect of Fas-induced apoptosis which enables penetration of CD4+ T-lymphocytes into exocrine tissue with its subsequent damage. However, development of corneal dystrophy is based not only on the inflammatory mechanism. Defects in transmembrane and secretory expression of mucin, disturbance of nervous stimulation of tear production, dysfunction of meibomian glands also lead to the development of various forms of dystrophy. Undoubtedly, there is a number of adverse factors, such as environmental influence and anatomical features, endocrine, inflammatory, autoimmune diseases and the use of contact lenses, drug use, or ophthalmic surgery.

The aim. To increase the effectiveness of treatment in patients with corneal degeneration by using oxygen therapy based on the correction of oxidative stress and mitochondrial dysfunction.

Materials and methods. We observed 80 patients (160 eyes) with corneal epithelial-endothelial dystrophy, herpetic and metaherpetic keratitis, neurotrophic keratitis (diabetes mellitus and glaucoma), neuroparalytic keratitis (lagophthalmos), which consisted of 4 groups. There were 44 men and 36 women. The patients’ age varied from 31 to 69 years. For research, we used a device allowing to obtain a new level of quality of liquid gas saturation. Different aspects of the therapy were studied: duration, density, concentration, etc. Clinical-laboratory and instrumental methods of examination of patients with degenerative diseases of the eye cornea were used in this study.

Results. As a result of degenerative-dystrophic changes of the cornea, irreversible and severe consequences can occur. Due to the chronic occurrence of epithelial defects of the cornea, corneal pannus and squamous metaplasia are formed leading to blindness. Unfortunately, there is only symptomatic treatment that can reduce the suffering of patients, but not cure the problem. Today a hot issue of ophthalmology is the search for new treatment options, one of which is oxygen therapy. For the first time, the role of components of the system of oxidative and mixidative stress in the development of degenerative-dystrophic diseases of the cornea has been established. New scientific knowledge on the importance of components of oxidative and mixidative stress in the mechanisms of vascular damage in corneal degeneration and the dependence of the detected disorders on the content of superoxide radical, hydroxyl radical, diene conjugates and malonic dialdehyde, which can open new possibilities in prevention and treatment of this pathology, was obtained.

Conclusions. The search for and research of new treatment options for patients with degenerative-dystrophic corneal diseases is relevant, as untimely and ineffective treatment can have significant implications for individual and public health. All this determined the relevance of research and determined the aim and objectives of this work. However, the still unsolved scientific and applied task of modern ophthalmic science is to study the effect of oxygen therapy on dystrophic corneal diseases and the functional state of the optic and nervous system which determined the aim and objectives of this work.

Keywords: corneal degeneration, corneal dystrophy, oxygen therapy, oxygen, oxidative, mixative stress, hyperoxic, hypercapnic drive.