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Etiology, pathogenesis, clinical features and treatment of the age-related cataract.


Author: Ion Jeru
Degree:doctor habilitat of medicine
Speciality: 14.00.08 - Ophthalmology
Year:2019
Scientific consultant: Eugeniu Bendelic
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 27 June, 2019 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document2.62 Mb / in romanian

Thesis

CZU 616.1.943

Adobe PDF document 16.00 Mb / in romanian
0 pages


Keywords

age-related cataract, immunogenesis, morphogenesis

Summary

Structure of thesis. The thesis is written in Romanian, has 170 pages and is composed of introduction, 6 chapters, conclusions, practical recommendations, abstracts in Romanian, Russian and English, bibliography of 204 sources. It containes 18 tables and 41 figures. The results of research are published in 109 scientific papers.

Field of study: ophthalmology.

Aim of the study: The aim of this thesis was to evaluate risc factors, morphological characteristics and the role of inflammation in the age-related cataract (ARC) development, clinical features as well as therapeutic possibilities to reduce postoperative corneal edema.

Study objectives. To investigate the inflammatory markers (pro- and anti-inflammatory cytokines) and growth factors concentrations in the aqueous humor of patients with different types of age-related cataract (capsular, cortical and nuclear) and with different stages of cataract (incipient, intumescent, mature), different locations of opacity and different comorbidities. To investigate morphological features of the anterior lens capsule in patients with age-related cataract. To evaluate the role of oxidative stress in the pathogenesis of age-related cataract, postoperatory corneal edema and secondary cataract.

To evaluate clinical features of age-related cataract. To evaluate the relationship between inflammatory markers in the aqueous humor and corneal edema after extracapsular cataract extraction and phacoemulsification. To evaluate the therapeutic effect of Aspirin, Aevit and Quinax combination in patients with incipient ARC, evaluated by the markers of inflammation and oxidative stress. To investigate peculiarities of the medical and microsurgical treatment in patients with age - related cataract and reveal some postoperative complications.

The scientific novelty and originality. The concentration of pro- and anti-inflammatory cytokines, chemokines and growth factors was determined in aqueous humor of patients with different stages of age-related cataract and markers implicated in the pathogenesis of ARC were identified. The morphological features of the anterior lens capsule in patients with age-related cataract were determined and the mechanisms of immunogenesis and morphogenesis were identified.

Theoretical significance. The role of increased inflammatory response in the development of ARС has been shown. Morphological alterations in the anterior lens capsule were determined (changes of capsular collagen, subcapsular epithelium and fibrils).

The important scientific problem solved in field of research consists in identification of pathogenic mechanisms of ARC, revealed by determination of inflammatory response and morphological alterations of anterior lens capsule. As a result of investigation, we elaborated a diagnostic and treatment algorithm for patients with ARC.

The applicative value of the study. The inflammatory markers in aqueous humor that have the most important role in the pathogenesis of ARC and the benefits of Aspirin, Aevit and Quinax combination in reducing the postoperatory complications, inflammation and oxidative stress have been determined.

Implementation of scientific results. The study results were implemented in the clinical activity of Departments of Ophthalmology at hospitals in Chișinău as well as in the research and didactic activities of Nicolae Testemițanu State University of Medicine and Pharmacy.