Патофизиологическое обоснование специфики заболеваемости офтальмологического профиля в Арктическом регионе

Abstract

Aim. To carry out a pathophysiological substantiation of the specificity of diseases of the organ of vision, developing under the influence of a complex of climatic and geographical factors of the Arctic region. Materials and methods. Using a retrospective epidemiological method of case-control study on the basis of branch No. 8 of FGKU 1469 VMKG of the Ministry of Defense of Russia, an analysis of the morbidity structure by ophthalmological profile for a three-year period (2018-2020) among military personnel aged 18 to 45 years military service in the Novaya Zemlya archipelago, Belushya Guba village. The method of analytical observation and data recording was used to assess the complex of unfavorable climatic and geographical factors of the Arctic region on the example of the Novaya Zemlya archipelago, Belushya Guba village. On the basis of an integral assessment of epidemiological and climatogeographic observations, a pathophysiological substantiation of the specificity of nosological groups of diseases of the organ of vision, developing under the influence of a complex of unfavorable factors of the Arctic region, is given. Results. The study involved 237 people. During the study period, 540 requests for ophthalmological help were registered. Of these, 64.26% are pathologies of inflammatory genesis, 32.6% are refractive disorders, 3.14% are diseases, the pathogenesis of which is associated with metabolic disorders in the body. The pathophysiological substantiation of the revealed morbidity structure according to the ophthalmological profile is due to the influence of a complex of unfavorable climatic and geographical factors of the Arctic region. Under the influence of wind and low temperatures, the structure of the tear film changes, the secretion of the meibomian glands becomes more viscous, as a result of which its concentration in the tear fluid decreases, and the eyes lose their protective barrier. The congealed secret clogs the ducts of the meibomian glands, which leads to their inflammation – meibomyitis. In turn, the insufficiency of the tear film provokes a decrease, and in more severe cases, a complete loss of natural tear production and the development of dry eye syndrome. The development of acute and chronic conjunctivitis is facilitated by a decrease in the reactivity of the body due to hypovitaminosis against the background of exposure to irritating climatic factors. With inflammation of the mucous membrane of the eyelids, the frequency of inflammatory diseases of the lacrimal ducts and the lacrimal gland increases, which causes obstruction of the lacrimal tubules and hyperfunction of the lacrimal glands. On a polar night, the perception of bright lighting is aggravated, a long stay near which provokes the development of a spasm of accommodation and subsequently its habitual excessive stress. Lack of natural light during the polar night is a predisposing factor for the development of myopia. In addition, during the polar night, there is a high probability of developing A-vitamin deficiency, which results in impaired night vision, damage to the conjunctiva, and in more severe cases, the cornea. In the spring or early summer, when there is snow, and solar activity is high, the ultraviolet rays reflected from the snow enter the eyes, causing a retinal burn, ultraviolet ophthalmia develops. Conclusion. The impact of a complex of climatic and geographic factors of the Arctic region on the body provokes a restructuring of regulatory physiological processes and the launch of pathogenetic mechanisms leading to the emergence and development of inflammatory diseases of the eye and its accessory apparatus, refractive disorders, as well as pathology, which is based on metabolic disorders.