Method for the treatment of herpetic keratitis with ulceration

 

(57) Abstract:

The invention relates to medicine, in particular to ophthalmology, and can be used for treatment of herpes eye diseases, namely hermetic keratitis. In the conjunctival cavity injected eye drops Aftermodern at a concentration of 20000 IU/ml, after which a non-contact method of conducting the procedure magnetophoresis using an alternating magnetic field induction 10 MT and a frequency of 25 Hz, a duration of 8 min 1 per day. Antiviral and anti-inflammatory effects are manifested in the form of a full and rapid epithelialization of the cornea, resorption infiltration in the absence of allergic reactions and reducing the input dose of Ophthalmoparesis and are achieved through a combination of medication antiviral activity with an alternating magnetic field. 2 C.p. f-crystals.

The present invention relates to the field of medicine, particularly ophthalmology, and is intended for the treatment of viral diseases of the eye caused by the herpes simplex virus.

Currently in ophthalmic practice for the treatment of patients with ophthalmic herpes, in addition to specific antiviral therapy, with the success of interferon and inducers of interferons (Y. F. Michuk "Viral diseases of the eye M, Medicine, 1981,S. 272).

Today in medical practice firmly established interferons as of natural origin, and recombinante (F. E. Ershov "the interferon System in norm and at a pathology." M, Medicine, 1996, S. 216). Drugs interferons are used in the clinic as an independent drugs and combination therapy to enhance antiviral (therapeutic) effect (M. A. Kazachenko and other "Locteron - new eye drops interferon in the treatment of viral diseases of the eye." W. New drugs, 1998, 10, 22-25; Y. F., Michuk and other "Acyclovir and acyclovir in combination with interferon in the treatment of ophthalmic herpes". Ophthalmological journal, 1991, 78-80).

Eye drops Ophthalmoparesis (recombinant 2-interferon), except for the interferon in high concentration (at least 20 000 ME) and components of the dosage form, contain antioxidant - Trilon B, an antihistamine is diphenhydramine. This combination of products allows us to strengthen anti-virus and anti-inflammatory and antiallergic effect.

Eye drops Ophthalmopathy developed in JSC "PIRP-M" represent a colorless solution. In vial contains not less evania, their numbers reduced to a 4-2 times a day as inflammation (Antiviral eye drops "Aftermodern", RU Patent 2140286, a 61 K 38/21, 1999.10.27).

This method is adopted for the nearest equivalent.

In the treatment of infectious-inflammatory diseases also applied with success physiotherapeutic methods such as magnetoterapia (MT). therapeutic effect of MT is that it improves blood flow to affected areas of tissues, increases the separation regeneration, activates the speed of the biosynthesis of collagen in the damaged cornea, increased transport of drugs into the eye. Thus, the magnet has a pronounced anti-inflammatory, anti-edematous, anti-allergic and reparative action (E. C. Weinstein and others, "Influence of magnetic field on the permeability of the cornea and gematologicheskogo barrier", Coll. "Magnetic fields in theory and practice of medicine", 1984, 60-64).

The technique of magnetic therapy, and in particular magnetophoresis, developed from experimental and clinical study (E. C. Weinstein and other "Magnetophoresis and its experimental validation, Ophthalmological journal, 1982, 4, 245-247).

and in particular with interferon, but it was used interferon preparations with low antiviral activity, and they must be diluted with saline or distilled water, which often caused toxic or allergic reaction.

The proposed combination of Ophthalmoparesis and magnetophoresis can give a new higher antiviral and anti-inflammatory effect, based on the fact that interferon is used in the form of ready-ocular dosage forms, which combines a high antiviral activity with antihistamine drugs (diphenhydramine), antioxidant (Trilon B), the absence of microbial contamination and provides a deeper penetration of the drug into the eye, in the absence of allergic reactions and by reducing the daily dose of interferon.

The technical result of the proposed method is a complete and rapid epithelialization of the cornea, resorption infiltration in the absence of allergic reactions.

The technical result is achieved by lowering the dose of Ophthalmoparesis (save epithelization and resorption infiltration) are introduced into the tissue of the affected eye once magnetophoresis method.

Treatment continues until complete epithelialization of the cornea (5-10 treatments).

Possible additional symptomatic therapy.

The results of clinical observations.

Example 1. The Magnetophoresis Of Ophthalmoparesis. Patient C-L. M., 64 years old, medical history, 2955, diagnosis: OD - tree keratitis defeat stroma, corneal clouding.

For the first time moved hermetic keratitis at the age of 10, was formed corneal opacity. Relapses in 1997 and 1988, after cooling, the present aggravation of 24 March 2000, was Treated at the place of residence within 7 days: ointment zovirax, taufon, gordox, solcoseryl gel, parabulbarno taufon, inside tavegil. When entering the right eye moderate horn syndrome, eyelid conjunctiva reactive hyperemic, peritoneally injection of the eyeball, in the Central zone of the cornea against the background of the old turbidity reasonable epitheliopathy, the site of ulceration of the epithelium and verhnostny and intermediate layers, weak Disamatic, retromobile weak swelling of the endothelium, a single small precipitates, acuity of 0.1, the degree of inflammatory response - 16 points.

When survey by the IAF in his right eye detected HSV antigen, seeding, sterile, blood and urine in norm. The patient received mydriatic, magnetophoresis with Ophthalmoparesis (7 procedures). Beginning epithelial recorded on the 2nd day of treatment, complete epithelialization occurred on the 4th day. Treatment added instillation of 0.001% solution of dexamethasone. On the 6th day finished fold descemetocele shell, on day 9 showed a clinical recovery, the visual acuity improved to 0.8, the HSV antigen in conjunctival scrapings with OD not found.

Example 2. Instillation Of Ophthalmoparesis. Patient H-I.,, 27 years old, medical history, 3350, diagnosis: OD tree keratitis defeat stroma, corneal clouding.

For the first time moved herpetic keratitis 3 years ago after OCR. The present exacerbation 5 days ago on the background of acute respiratory disease associated with herbes labialis. Were outpatients, buried interferon, solcoseryl. When entering the right eye is expressed corneal syndrome, eyelid conjunctiva moderately reactive hyperemic, expressed mixed injection with which reasonable epitheliopathy, diffuse edema and infiltration in the surface and intermediate layers in the Central area of ulceration in the form of a "tree branch", occupying 1/4 of the area of the cornea, weak Disamatic, iris rigid, narrow pupil, IOP palpable in normal, visual acuity was 0.1, the degree of inflammatory response - 16 points.

In the survey method MFA in scraping with the conjunctiva of the right eye detected HSV antigen, seeding, sterile, blood and urine in norm. The patient received atropine, local magnetophoresis with Ophthalmoparesis, instillation of Ophthalmoparesis 8 times a day, optional: gordox 1:10, bromohexyl, taufon, inside indomethacin, claritin. Initial signs of epithelialization was observed on day 3, complete epithelialization on day 7 of treatment, after which strengthened local anti-inflammatory therapy with instillation of naclof and 0.05% solution of dexamethasone reduced the instillation of Ophthalmoparesis to 4 times a day. Resorption of edema and infiltration of stroma occurred after 7 days, on day 13 showed a clinical recovery. The visual acuity improved to 0.4, the HSV antigen in conjunctival scrapings with OD not found.

Thus, the technical result is achieved due to the combination of medication (eye drops Itallie rapid relief of inflammatory processes in the eye, the disappearance of signs of iritis, resorption infiltration of stroma, increased visual acuity. Moreover, the acceleration of the healing process observed without the addition of drug treatment that promotes healing of ulcerations, characteristic of keratouveitis with the decline allergies.

1. Method for the treatment of herpetic keratitis with ulceration, including local injection eye drops Ophthalmoparesis at a concentration of 20000 IU/ml in the form of a magnetophoresis using a low-frequency alternating magnetic field of 1 times a day until complete epithelialization of the cornea.

2. The method according to p. 1, characterized in that use low-frequency alternating magnetic field when the value of the induction 10 MT, a frequency of 25 Hz.

3. The method according to p. 1, characterized in that Aftermodern injected into the conjunctival cavity.

 

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FIELD: medical engineering.

SUBSTANCE: device has container for keeping product to be applied, dosing unit for distributing the product, power supply element placed near the dosing unit. The dosing unit is designed as rotating element and is apiece of felt. Container walls are flexible. The dosing unit is manufactured from electric conducting material and connected to the power supply element.

EFFECT: enhanced effectiveness in carrying out viscous product iontophoresis.

8 cl, 7 dwg

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