Differentiated approach to the treatment of chronic conjunctivitis in post-COVID syndrome based on data laser doppler flowmetry

Purpose: to develop a differentiated approach to the treatment of chronic conjunctivitis in post-Covid syndrome based on laser Doppler flowmetry (LDF) data. Material and methods. The study included 66 patients (132 eyes) with chronic non-infectious conjunctivitis in the post-Covid period. All patients underwent LGF of the bulbar conjunctiva 3 months after SARS-CoV-2 infection. According to the results of LDF, patients were divided into 2 groups: 1-st with hyperemic and 2-nd with stagnant hemodynamic type of microcirculation. In each group, two subgroups were identified. Patients of subgroup 1-a (18 patients, 36 eyes) were prescribed topical antioxidant agent 3 times a day for 2 months, moisturizing preparations containing sodium hyaluronate 3 times a day, preparation containing heparin during the whole period of observation, systemically a preparation from the group of metabolic agents for 3 months. Patients of subgroup 2-a (15 patients, 30 eyes) were recommended instillations of preparations containing sodium hyaluronate 3 times a day, a preparation containing heparin during the whole period of observation and systemic administration of a preparation from the group of venotonics 3 months. Patients of subgroups 1-b and 2-b were treated with a preparation containing sodium hyaluronate 3 times a day. The effectiveness of therapy was monitored after 1, 3, 6 months. Results. After therapy hemodynamic parameters of microcirculation significantly improved. Correction of microcirculatory disorders contributed to normalization of perfusion in 3 months in patients of subgroup 1-a (M = 24.8 ± 5.5 p. u.), in 6 months in patients of subgroup 2-a (M = 26.3 ± 6.1 p. u.) and mechanisms of its regulation in 6 months in patients of subgroup 2-a (Kv = 15.2 ± 7.4 %). No statistically significant changes in microcirculatory parameters were registered in patients of subgroups 1-b and 2-b. Conclusion. Hyperemic or stagnant type of hemodynamic microcirculatory disorders, established by the evaluation of baseline indices (M, σ, Kv), serves as a basis for the choice of treatment tactics for chronic conjunctivitis in postconcussive syndrome.