TRANSPALPEBRAL RHEOOPHTALMOGRAPHY: FUNDAMENTALS AND RESULTS OF CLINICAL STUDIES OF MYOPIC CHILDREN

Purpose. To present the fundamentals of transpalpebral rheoophtalmography development and its clinical testing on myopic children. Material and Methods. In transpalpebral rheoophtalmography development, we used our own electrophysical multilayer eye model involving the choroid and the upper eyelid, a biotechnical tetrapolar electrode system and a device for its fixation. To assess the clinical potentials of transpalpebral rheoophtalmography, we examined 128 patients aged 5-22 (ave. 13±1.1 years) with myopia of various degrees. Of these, 35 children were examined before and after functional treatment and scleroplastic surgery. Another group consisted of 70 myopic children aged 13.03±0.28 years, who were examined before and after a low-invasive sclera reinforcement procedure in which biologically active grafts were used. A comparative parallel study of transpalpebral rheoophtalmography and color Doppler ultrasonography involved 17 children (34 eyes) aged 12.5±1.8 with various clinical refractions. Results. The modeling helped assess the contribution of the eyelid blood supply into the rheographic index (which was found not to exceed 16%), demonstrated the need to replace the bipolar electrode system used in traditional rheoophtalmographyа with a tetrapolar system which provides more complete data on pulse blood filling of the choroid and ensures optimal positioning of the electrodes on the eyelid. A special helmet was designed to fix the electrodes and adjust their pressing force. We also developed a program for an automatic analysis of transpalpebral rheoophtalmography signals. A statistically significant rheographic index drop accompanying refraction increase was revealed. Rheographic index increased after functional and surgical treatment of myopia. transpalpebral rheoophtalmography was found to be more informative than Doppler ultrasonography when examining children with low and moderate myopia. Conclusion. The fundamental approach to the development made transpalpebral rheoophtalmography a highly informative and precise method of objective assessment of blood supply to the choroid. Transpalpebral rheoophtalmography uses low-cost equipment, is convenient, mobile, requires no contact with the eye and takes little time to be applied, which is especially important in pediatric practice. Transpalpebral rheoophtalmography may be used to produce new data on the pathogenesis of eye diseases, to ensure their early diagnosis and monitoring, and to assess the effectiveness of treatment.

hemodynamics, myopia, children, eye model, rheographic index