FEATURES OF THE DYNAMICS OF THE II DEGREE OF SEVERETY BACTERIAL KERATITES IN DIABETIC PATIENTS AT DIFFERENT STAGES OF DIABETIC POLYNEYROPATHY

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Summary. The neuro-trophic condition of the cornea affects the healing process of corneal defects in patients with keratitis, causing the severity, duration and consequences of the disease.
 The aim was to identify the features of the dynamics of the II degree of severity bacterial keratitis in patients with diabetes mellitus (DM) at different stages of the severity of diabetic polyneuropathy (DPN).
 Materials and methods. The results of treatment of 19 patients with bacterial keratitis of the II degree of severity and type 1 DM were analyzed. II degree of severity of bacterial keratitis was determined according to our proposed scheme at a sum of points 15-21. All patients were treated with instillations of the antibiotic ofloxacin, antiseptics, antioxidants, reparants, artificial tears, mydriatics, systemic anti-inflammatory therapy. Patients were divided into two groups according to the severity of DPN: with symptomatic (first group) and stage with impaired DPN (second group). In addition to standard, ophthalmic examination methods included bacteriological examination, fluorescein test, OCT of the anterior segment of the eye, non-contact corneal esthesiometry.
 Results and discussion. In most patients of the second group, corneal sensitivity and depth of edema of the corneal tissues surrounding the ulcer, the size of the ulcer defect and the depth of corneal infiltration, the degree of pericorneal injection, the depth of the corneal ulcer defect from the 1st, 7th, 10th and 14th days of observation, respectively, were higher than in patients of the first group (p<0,05). The consequence of the disease in patients of the second group was more severe than in patients of the first group.
 Conclusions. In patients with the stage of impaired DPN, bacterial keratitis is characterized by a longer duration and severity of clinical symptoms, as well as worse consequences of the disease than in patients with symptomatic DPN.