Electrophysiological, functional and morphometric state of the optical nerve in patients with purulent meningitis during reconvalescence

Abstract

Aim of the study. Determine the condition of the optic nerve head in patients with purulent meningitis during the period of convalescence according to the data of functional, electrophysiological examination (EPE), and morphometric examination.

Material and methods. We examined 69 patients (48 – comparison group – patients treated in the infectious diseases ward of the Regional Clinical Hospital named after N.A. Semashko (Ryazan) with a verified diagnosis of purulent meningitis; 21 – control group – conditionally healthy volunteers without neurological, ophthalmological and otorhinological pathology). The patients were examined twice by an ophthalmologist (with a visual examination of the optic nerve head (optic nerve disc): in the acute period and in the follow-up period from the moment of discharge from the hospital up to 3 months inclusive. During the period of convalescence, the patients underwent a morphometric examination of the optic disc using an optical coherence tomograph (OCT Stratus, Germany). The EFE of the optic nerve was assessed using electroretinography and visual evoked potentials (VEP) using the complex neurophysiological equipment Neurosoft (Ivanovo, Russia).

Results. Analysis of clinical and neurological symptoms in patients with purulent meningitis during the period of convalescence showed a high frequency of complaints of light sensitivity of 89.9%. A higher frequency of detection of stagnant optic discs during the period of convalescence (within 3 months from the moment of discharge from the hospital) in patients with purulent meningitis was revealed. A significant decrease in photosensitivity was found in 90% of patients in the comparison group during the follow-up period (p<0.01). OCT indices were changed in 60% of patients in the comparison group. Evaluation of VEP parameters and electroretinography of the comparison group revealed disorders of visual afferentation in 87.5% of patients.

Conclusion. The analysis of the results of the optic nerve disc study in patients with purulent meningitis during the period of convalescence makes it possible to recommend a complex of functional, EPE, and OCT of the optic nerve in order to diagnose and correct visual disorders in these patients.

Keywords:purulent meningitis, damage to the optic nerve

Funding. The study was not sponsored.

Conflict of interest. The authors declare that there is no conflict of interest.

Contribution. Concept and design of the study – Khasanova L.A., Martynov V.A.; collection and processing of the material – Khasanova L.A.; statistical processing – Khasanova L.A.; writing of the text – Khasanova L.A.; editing – Martynov V.A., Khasanova G.M., Tutelyan A.V.

For citation: Khasanova L.A., Martynov V.A., Khasanova G.M., Tutelyan A.V. Electrophysiological, functional and morphometric state of the optical nerve in patients with purulent meningitis during reconvalescence. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2021; 10 (3): 67–73. DOI: https://doi.org/10.33029/2305-3496-2021-10-3-67-73 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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