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    Vasyuta V. A.

    EVALUATION AFFECTING FACTORS OF THE EARLY DETECTION OF OPTIC NERVE ATROPHY


    About the author: Vasyuta V. A.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation The problem of the origin and progression of optic atrophy (ONA), despite numerous attempts to solve the scientific community remains socially relevant and meaningful. ONA - polietiological disease that requires a comprehensive approach taking into account history (presence of severe somatic diseases, hypertensive syndrome), data of laboratory and instrumental investigations, consultation with experts of related professions (neurologist, neurosurgeon, cardiologist, etc.). Objective. To study the main factors affecting the early detection of ONA. Materials and methods. We analyzed medical records and history, standard ophthalmologic research conducted to identify ONA: study visual acuity, direct and reverse ophthalmoscopy, biomicroscopy, computer perimetry. Patients were divided into 2 groups. The first group (330) - patients with a rising ONA (a consequence of ophthalmic diseases), the second group (1667) - patients with descending ONA (consequence of the diseases of central nervous systemat). Evaluated residence in urban areas, completeness ophthalmologic, general clinical investigations, completeness advice and collecting history. For the purpose of extrapolating the results to the general population was defined confidence interval of 95% probability assessment. To determine the statistical significance of the difference in the comparison group was used Pearson x2 test. For prognostic evaluation parameters that affect the likelihood of early detection of ascending and descending forms ONA spent determining the odds ratio with 95% confidence interval (95% CI) and assessment of the impact of heterogeneous factors (I2). Results. Analysis of the results showed a significant difference for the studied parameters in different types of ONA and residents in villages and towns. More late diagnosis of ONA observed in villagers (in up to 3 months turns 28,6% of rising ONA and 3,3% downward ONA), the inhabitants of the cities, these figures are 59,5 and 8,9% respectively. The situation with a longer diagnosis ascending ONA villagers due to the lower availability of high quality medical care for rural residents. Living in a city increases the likelihood of early diagnosis of ascending ONA in 3,67 times, the availability of a complete eye examination at 4,03 times, full general clinical examination - in 3,05 times (p <0,01). Regarding downward ONA, statistically significantly increased the likelihood of early diagnosis in the implementation of the following factors: completeness general clinical examination (4,2 times), completeness advice (3,4 times) and complete history taking (in 4,0 times) ( p = 0.001). Descending ONA is the most difficult for primary diagnosis. Carrying only ophthalmic research is not sufficient for the diagnosis and requires a comprehensive approach. Conclusions and practical recommendations. The data make it possible to identify priorities for relief to patients with ONA, namely a comprehensive approach to diagnosis taking into account not only ophthalmologist but general clinical examination, expert advice related specialties and careful history taking. It is importan differentiated approach to the diagnosis of ascending and descending forms of ONA requiring an accurate diagnostic algorithms to improve medical assistance to this group of patients.
    Tags optic nerve, atrophy, evaluation affecting
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    Publication of the article «World of Medicine and Biology» №3(51) 1 part 2015 year, 011-015 pages, index UDK 616.731-007.23-036.6