Research work - Department of Ophthalmology

Scientific topic of the department of ophthalmology:

“Improving methods of diagnosis and treatment of certain types of eye diseases with the development and implementation of new dosage forms into ophthalmological practice”
There are 3 professors, 4 associate professors in the department of ophthalmology, 5 of them have degree of Doctor of Medicine, 7 teachers have PhD degree.
In 2022, 4 dissertations for the PhD degree were successfully defended at the department:
Bektemirova Norbuvi Tukhtaevana on the topic “Features of anesthesia in geriatric patients in ophthalmic surgery”
Oripov Okilkhon Ilyos ugli na temu “Cavernous sinus thrombosis associated with COVID-19: characteristics of ophthalmological symptoms, treatment and prevention”
Matkarimov Akmal Karimovich on the topic “Regional features of the clinical course and treatment of some eye diseases in the region of the South Aral Sea.”
Oralov Behruz Abdukarimovich on the topic “Clinical-laboratory assessment of the effectiveness of complex treatment of eye burns”

From 8 to 19 October 2019 in the center of the IRTC Microsurgery of the Eye. S.N. Fedorov, staff of the Department of Ophthalmology, Associate Professor Zakirhodzhaev R.A. and assistant Mirkomilov E.M. Wetlab Phacoemulsification Cataract Advanced Training Course. During the training, the department staff fully mastered the modern methods of cataract treatment. Also during this course, there were lectures such as the basics of phacoemulsification, the technique of implementation and complicated cases during operations. In addition, they qualified to operate on modern equipment.

On the Department of ophthalmology of the Tashkent Medical Academy there are 3 doctors of medical sciences, professors, 4 candidates of medical sciences, assistant professor, two assistant faculty conduct scientific work on the approved topics of candidate dissertations.
Over the past 5 years, the department staff published 114 articles, 55 of which in foreign journals, 193 theses, 62 of which in foreign collections of materials of international conferences, issued 8 methodological recommendations.
In 2017, the monograph “Improving the treatment of inflammatory eye diseases” was published.
Under the guidance of professors F. Bahritdinova. and Bilalov E.N. 5 Doctor’s and 15 Candidate’s theses are protected.

SCIENTIFIC PROBLEM OF THE CHAIR
“Improving the methods of diagnosis and treatment of certain types of eye diseases with the development and introduction of new dosage forms in ophthalmic practice.”
State registration number No. 011500212
THEMES OF DISSERTATION WORKS APPROVED AT THE DEPARTMENT IN 5 YEARS

– Islamov Z.S. “Improvement of diagnosis and treatment of retinoblastoma in Uzbekistan” (for the degree of Doctor of Medical Sciences, specialty 14.00.08 – Ophthalmology).
– Narzikulova K.I. “Development and clinical and experimental evaluation of the effectiveness of the complex treatment of inflammatory diseases of the eye surface” (for the degree of Doctor of Medical Sciences in specialty 14.00.08 – Ophthalmology).
– Zakirkhodzhaev R.A. “Systemic approach to diagnosis and treatment of the pathology of the optic nerve” (for the degree of Doctor of Medical Sciences in specialty 14.00.08 – Ophthalmology).
– Yusupov A.F. “Complex assessment of the functional state of the eye with age-related macular degeneration and choice of treatment tactics” (for the degree of Doctor of Medical Sciences, specialty 14.00.08 – Ophthalmology).
– Savranova TN “Clinico-pathogenetic aspects of the development of neovascular glaucoma, ways to optimize diagnosis and treatment” (for the degree of candidate of medical sciences in specialty 14.00.08 – Ophthalmology).
– Ashirmatova H.S. “Improving the prognostication and prevention of the risk of developing retinal vein thrombosis” (for the degree of candidate of medical sciences, specialty 14.00.08 – Ophthalmology).
– Aksha Kher “Vitreal Surgery in the Treatment of Patients with Proliferative Diabetic Retinopathy and Cataracts (Prognostic Aspects)” (for the degree of Candidate of Medical Sciences in specialty 14.00.08 – Ophthalmology).
– Karimov U.R. “Clinico – functional features and differentiated tactics of treatment of various forms of open – angle glaucoma” (for the degree of candidate of medical sciences in specialty 14.00.08 – Ophthalmology).
– Kangelova G.E. “Influence of complex therapy on clinical and functional parameters of the eye in nonproliferative diabetic retinopathy” (for the degree of candidate of medical sciences, specialty 14.00.08 – Ophthalmology).
– Imomalieva K.M. “Complex evaluation of the effectiveness of ocular medicinal films in the treatment of viral eye diseases in the experiment and in the clinic” (for the degree of candidate of medical sciences, specialty 14.00.08 – Ophthalmology).

SCIENTIFIC NOVELTY AND PRACTICAL SIGNIFICANCE OF CONDUCTED RESEARCH
For the first time, effective in the treatment of inflammatory diseases of the eye surface and safe dose for the organism, and radiation power on the equipment of the domestic production of ALT “Vostok”, the regenerative, anti-inflammatory and epithelizing properties of the proposed complex treatment with photodynamic therapy were determined.
For the first time in the experiment, the dynamics of biochemical blood indices under the influence of PDT was studied.
For the first time in ophthalmic practice in the complex treatment of inflammatory eye diseases, the effectiveness of the domestic equipment for photodynamic therapy of ALT “Vostok” has been proved.
A new improved scheme for the treatment of inflammatory eye diseases with PDT is proposed.
The state of endothelial intoxication and peroxidation of lipids on the course of the inflammatory process was assessed using the proposed complex treatment.
The study of the prevalence of retinoblastoma in children in Uzbekistan, the study of the causes of late detection of patients, proposed an effective early detection, diagnosis and methods for the comprehensive treatment of retinoblastoma (surgical, chemo, etc.).
Clinical, laboratory and molecular-genetic parallels in patients with retinal vein thrombosis in the local population will be characterized. The prevalence of allelic and genotypic variants of the FII, GV210A, FV (Leiden), MTHFR (C677T) and PAI-I genes in patients with retinal vein thrombosis and in the control group and the relationship between clinical course of retinal vein thrombosis and features of “functional adverse” allelic variants of these genes.
The results of the research will broaden the understanding of the etiological factors of development and the clinical course of retinal vein thrombosis, and will contribute to the creation of a basis for improving the criteria for early detection and treatment and prophylaxis of patients with retinal vein thrombosis. The results of the study will be the basis for the development of screening programs to identify individuals who are predisposed to heredity-burdened thrombosis of retinal veins.

The introduction of the developed modified operation with implantation of xenocollagen drainage with neovascular glaucoma will ensure a long normalization of intraocular pressure, stabilization of visual functions and a decrease in the intensity of antihypertensive therapy in cases of its necessity.
The use of the developed tactics of intraoperative and postoperative management of patients with neovascular glaucoma, as well as indications and contraindications to the use of a new modified method of surgical treatment of neovascular glaucoma will help reduce the number of postoperative complications, provide not only a stable hypotensive effect, but also an increase in visual functions in the majority of patients.
The study of genetic mechanisms of predisposition to the development of neovascular glaucoma will allow to carry out preventive measures in persons who are at risk of developing neovascular glaucoma.
As a result of the study, a clinically and economically most effective modification of the vitrectomy method in patients with diabetes mellitus complicated by the initial stage of PDD will be proposed, which will significantly reduce the number of intra and postoperative complications, shorten the period of recovery of visual function and improve the efficiency of surgical treatment.
A study will be made of the effect of cataract surgery at various stages (before, after and during vitreoretinal intervention) on visual function, anatomical treatment success and frequency, and the structure of intra- and postoperative complications, and the frequency of ophthalmic hypertension.
Clinical forms of manifestations, prevalence and risk factors for the development of glaucoma in the country will be studied. The information obtained on the prevalence of glaucoma in the country, on the risk factors for the development of the disease, will allow the heads of medical institutions of the ophthalmological profile to develop adequate measures for the prevention, detection and treatment of glaucoma in various regions of the republic. A differentiated algorithm will be developed for the treatment of primary open-angle, pseudoexfoliation and pigmentary glaucoma for practical ophthalmology.
For the first time, the effectiveness of GLP with an interferon inducer on the model of exogenous viral inflammation of the eyes has been experimentally proved.
The dynamics of the antiviral effect of HLP was studied according to the histomorphological tissues of the eye in the experiment.
The use and efficacy of GLP in the treatment of patients with HDM according to clinical and immunological parameters are substantiated.
A pathogenetically grounded complex treatment for non-proliferative diabetic retinopathy using the antioxidant and neuroprotective drugs – Tanakan and including physiotherapeutic effects (endonasal electrophoresis with tanakan) will be developed.
Correlation of clinico-hemodynamic parameters of the eye and biochemical parameters of tear fluid in non-proliferative diabetic retinopathy will be studied.
A comprehensive method of treatment for non-proliferative diabetic retinopathy will be developed with the inclusion of the pathogenetically significant drug Tanakan.

BRIEF DESCRIPTION OF THE RECEIVED RESULTS
An effective scheme for early detection, diagnosis, and methods for the complex treatment of retinoblastoma (surgical, chemo, etc.) has been developed.
The effectiveness of the method of vitreal surgery in the treatment of patients with PDR was studied depending on various methods of laser coagulation of the retina. differences in the frequency of perioperative complications in the case of isolated vitrectomy and combined intervention-fakovitretomy were not detected.
The effectiveness of xenocollagen drainage in neovascular glaucoma was assessed. The visual functions in the patients of the main group increased on average by 100% of the initial, while in the control group there was a slight decrease in visual acuity. At the time of observation, up to 24 months after the operation, pain syndrome was stopped in all patients.
An algorithm for early diagnosis (using molecular genetic methods of investigation) and effective treatment of retinal vein thrombosis and their complications are developed.
PDT in the developed scheme of treatment contributes to the effectiveness of treatment of inflammatory diseases of the eye surface: acceleration of tissue regeneration on days 5-6, restoration of the transparency of the cornea in 86.6% of cases, increase of visual functions in 86.7% and reduction of treatment time to 5-6 days .
In the tear fluid of patients with inflammatory diseases of the eye surface, the level of MDA increases, against the background of a decrease in catalase activity and imbalance in the LPO / AOZ system, especially in patients with keratitis. The use of photodynamic therapy in the complex treatment of patients with inflammatory diseases of the ocular surface activates catalase and reduces the high level of MDA, especially in keratitis, reduces the degree of endogenous intoxication and promotes the acceleration of the reparative processes of the conjunctiva and the cornea.
The obtained data of histo – morphological, immunological and clinical indices allow estimating the effectiveness of GLP in the treatment of CDV.
The developed complex scheme of treatment with the inclusion of GLP will increase the effectiveness of treatment of TZH.

IMPLEMENTATION OF RESULTS OF RESEARCH IN PRACTICAL OPHTHALMOLOGY OF UZBEKISTAN
The results of the study are presented in the form of methodological recommendations “Evaluation of the effectiveness of primary chemotherapy in intraocular tumors”, “Features of the clinic and diagnosis of retinoblastoma”, “Method for improving the effectiveness of treatment of inflammatory diseases of the eye surface”, “Comparative evaluation of the effectiveness of fixed combined antihypertensive drugs in POAG patients” Intraoperative and postoperative complications in vitreoretinal surgery of proliferative diabetic retinopathy “, which Nedra in practical public health (Ministry of Health and approved by the Academic Council of the TMA and RORC).
Algorithm of early diagnostics (using molecular genetic methods of research) and effective treatment of retinal vein thrombosis and their complications is introduced into the practical activities of the RSMC.
According to the new modification of the operation for neovascular glaucoma, patent No. IAP 04320 “Deep sclerectomy method” issued by the State Patent Office of the Republic of Uzbekistan was obtained. A computer program was developed – “A program for the rehabilitation treatment of patients with neovascular glaucoma,” which was registered with the Agency for Intellectual Property of Uzbekistan No. DGU 02641. This development was presented at the 5th Republican Fair of Innovative Ideas, Technologies and Projects. The results of the work will be implemented in the Republican Specialized Center for Eye Microsurgery, the Urgench branch of the RSMHG. The results of the research will be included in the program of lectures and practical classes for students of the master’s degree and clinical residents of the Department of Eye Diseases TMA and TashPMI.
The introduction into the practice of ophthalmology of the Republic of eye therapeutic films with an inducer of domestic interferon will allow not only to increase the effectiveness of treatment, but also to reduce the cost of treatment of inflammatory diseases of the eye.