https://doi.org/10.30702/Ophthalmology.2019/09.094253 

Moyseyenko N. M.

Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

Abstract. Ultrastructural changes in the retina during traumatic optic neuropathy (TON) treatment were studied. Our previous studies experimentally confirmed that after the damage to the orbital part of the optic nerve, within the background of high-dose corticosteroid monotherapy, not only the structure of the cranial part of the optic nerve restores but also its functional activity improves, by the example of zoonotic reactions to light. It was detected that phosphene electrostimulation (PES) of the contralateral side, due to retino-hypothalamic bonds, changes the architectonic nature of the suprachioscular nucleus of the hypothalamus, which, in turn, leads to the increase in the production of endogenous corticosteroids. In our opinion, this mechanism could be an alternative to the comprehensive treatment of TON. Decrease in the doses of corticosteroid infusions would reduce their toxicity, stimulate production of endogenous hormones and provide the necessary neuroprotective effect.

The purpose of the study was to investigate the changes in the retinal ultrastructure in traumatic optical neuropathy in response to neuroprotective therapy.

Methods. Ninety rabbits were treated with methylprednisolone 30 mg/kg only or with methylprednisolone 15 mg/kg in combination with phosphene stimulation with a current strength of 800 mA on the side of the lesion and 300 mA contralaterally.

Results. According to our research, traumatic damage to the orbital part of the optic nerve causes colliquative necrosis of ganglion cells and retinal nerve fibre layer oedema. Corticosteroid megadose monotherapy has resulted in a partial restoration of morphological parameters of the ipsilateral retina. Combination therapy with phosphene electrostimulation was characterized by the decrease in the retinal thickness, reduction of cytokaryometric indices and regeneration processes in bipolar and ganglionic neurons.

Conclusion. Thus, combination therapy of TON with the use of phosphene electrostimulation may be an alternative to conventional treatment, since it allows reducing the dose of corticosteroid infusions and provides the necessary neuroprotective effect.

Keywords: traumatic optical neuropathy, retina, neuroprotective therapy, phosphene electrostimulation.

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Received: 29 Oct 2018

Published: April 2019