Клинико-функциональные результаты комплексного лечения синдрома сухого глаза на фоне хронического периферического увеита

Abstract

Relevance. Inflammation and impaired stability of the pre-corneal tear film are central to the pathogenesis of dry eye disease (DED). Signs of ocular surface irritation and symptoms characteristic of DED accompany intermediate uveitis in 28–57 % of cases. Purpose. To evaluate clinical and functional results of treatment of DED and intermediate uveitis, including tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus. Materials and methods. The results of treatment of 78 patients with DED and intermediate uveitis were analyzed. The effectiveness of the developed method of treatment of combined pathology was evaluated after 3, 6, 12, 18 months based on the dynamics of OSDI index, hyperemia of bulbar conjunctiva, LIPCOF test, Schirmer I test and Norn's test. Results. Application of complex treatment of DED in patients with intermediate uveitis promotes statistically significant (p≤ 0.05) decrease of discomfort signs according to OSDI results up to 34.7 %, decrease of bulbar conjunctiva hyperemia index up to 50 %, decrease of LIPCOF test index up to 27.2 %, increase of tear film rupture time up to 31.6 % and total tear production up to 89.7 % with stable cure of intermediate uveitis during 18 months of observation. Conclusions. Tear replacement and anti-inflammatory therapy in combination with laser retinal coagulation at the extreme periphery of the ocular fundus is an effective method of treatment of DED and intermediate uveitis, providing stable clinical and functional results for a long time. Keywords: dry eye disease, intermediate uveitis, laser coagulation of the extreme periphery of the retina