Method of conservative treatment of hemophthalmia different genesis

 

(57) Abstract:

The invention relates to medicine, namely to ophthalmology, and for the treatment of hemophthalmia. For this retro-bulbar space two times a day injected sequentially at intervals of 30 min, drugs from groups: anticoagulants, corticosteroids, antioxidants and angioprotectors, and between the morning and evening stages of the drug on the eye for 10 minutes effect of pulsed magnetic field with the repetition period of pulses from 4 to 20, the tension 12-15 MT and a frequency of 50 Hz. The method allows to intensify the process of treatment of the case by creating a high concentration of drugs in the posterior segment of the eye and the strengthening of their actions under the influence of pulsed magnetic fields. 1 C.p. f-crystals.

The invention relates to medicine, in particular to ophthalmology, and can be used in the treatment of hemophthalmia.

Known conservative method of treatment of hemophthalmia using fibrinolizina by introducing 1-7 injection subkonyunktivalno with an interval of 1-3 days. (N. So Mkhitarian, A. D. Shvets. "In Proc. materials of scientific-practical conference, Moscow ophthalmological society. M, 1976, S. 107).

Under the invasiveness and high probability of adverse reactions, as fibrinolysin is a protein and antigenic properties.

It is known the use of intravascular laser irradiation of blood in treatment of hemophthalmia. (D. E. Deyneka, I. A. Zakharov, N. B. Lobaev. "In Proc. Ophthalmology Central black earth region and the Middle Volga region in the solution of the problem of blindness and low vision. Tambov, 1997, S. 145).

The disadvantages of this method include low efficiency and the complexity of the procedure.

For the treatment of hemophthalmia in diabetic retinopathy proposed the use of extended peripheral transscleral cryopexy retina in combination with intravenous introduction of recombinant prourokinase (gamasy). (A. P. Nesterov, L. M. Balashov and other abstracts of the VII Congress of ophthalmologists of Russia, part I, S. 470).

The disadvantages of this method are the limited application and the unavailability of the specified drug.

Closest to the proposed method of treatment of hemophthalmia to the technical essence and the resulting effect is a comprehensive treatment of hemophthalmia. In particular, the known method, including claritinpaxil and occupational therapy against medical treatment. The method gives the possibility of use, recommended as a preparatory stage for laser treatment (O. I. Yuzhakova, HP Barabanova, and So M Zarenkov. "In Proc. Eroshevsky reading, Samara, 1977, S. 377).

In the message, O. I. Jacoway al. described the possibility of use in treatment of hemophthalmia magnetic therapy against medical treatment. (In Coll. Volga dawns, Samara, 1998, S. 249. The prototype).

The objective of the invention was to develop an efficient, simple in design and are available in wide clinical practice, complex conservative treatment of hemophthalmia various origins.

The essence of the invention lies in the fact that in the retro-bulbar space, through previously implanted catheter twice a day consistently administered, at intervals of 30 min, drugs from groups: anticoagulants, corticosteroids, antioxidants and angioprotectors, and between stages of the drug on the eyes exposed for 10 min pulsed magnetic field with the repetition period of pulses from 4 to 20, the tension 12-15 MT and a frequency of 50 Hz. The course of treatment is 10 days.

The technical result achieved by implementation of the proposed izobretatel in the posterior segment of the eye and the strengthening of their actions under the influence of pulsed magnetic fields. When you do this consistently are certain stages of destruction of hemophthalmia and elimination from the vitreous body of decay products:

- inhibition of the conversion of fibrinogen to fibrin, the inhibition of blood clots, reducing the aggregation of blood and improve blood flow;

- inhibition of the formation of connective tissue, accelerated protein breakdown in the case of the products of hemolysis of erythrocytes, hemoglobin and lipids;

- open circuit or inhibition reactions of lipid peroxidation and formation of hydroxyl radicals, providing a damaging effect on the surrounding tissue;

- improving the sustainability of the capillaries, the normalization of permeability and microcirculation of blood;

under the action of magnetic fields vessels dilate, increases the permeability of cell membranes, which enhances the effect of administered drugs on the destruction of hemophthalmia and the elimination of the decay products.

The proposed method for the treatment of hemophthalmia as follows. After conducting traditional anesthesia in the retro-bulbar space implanted catheter with funnel with lid, and fix its outer end on the forehead. Cher is in, enter drugs from groups: anticoagulants, corticosteroids, antioxidants, angioprotective.

Between the stages of administration of drugs to the eye is affected by a pulsed magnetic field with intensity 12-15 MT, 50 Hz repetition period of the pulses from 4 to 20 C. the Duration of the treatment is 10 minutes, the Course of treatment is 10 days.

To control the functional state of the eye used diagnostic methods: ophthalmoscopy, electrophysiological studies (thresholding electrical sensitivity and lability of the optic nerve), biomicroscopy and-scan. A method of treating hemophthalmia is illustrated by the following clinical examples.

Example 1.

Patient T., aged 60 years, outpatient map 103858.

Diagnosis: hemophthalmus left eye on the background of hypertension.

Survey data.

Visual acuity OS - 0,01.

Diffuse opacities of the vitreous body.

EPE: the threshold - 160 ľa.

Electrical lability - 29 Hz.

After the anesthesia to the patient in the retro-bulbar space implanted catheter, through which

10.00 - emoxipin 1% 0.5 ml

10.30 - dicine 12,5% 0.5 ml

The final stage in the morning session of treatment is exposure to the eyes pulsed magnetic field in the above-described mode.

Evening treatment: similarly in the retro-bulbar space was injected drugs:

17.00 - 750 IU heparin

17.30 - dexason 2 mg

18.00 - emoxipin 1% 0.5 ml

18.30 - dicine 12,5% 0.5 ml

The course of treatment is 10 days.

Survey data at the end of treatment.

Visual acuity OS - 0,8 n/K.

The vitreous body was considerably brightened.

EPE: the threshold electric sensitivity -110 ľa.

Electrical lability - 31 Hz.

Thus, as a result of treatment the patient has happened resorption case of the improved electrical Fofana and significantly improved visual acuity.

Example 2.

Patient G., aged 56 years, AMB. map 100462.

Diagnosis: hemophthalmus left eye, peripheral retinovascular both eyes.

Survey data.

Visual acuity - 0.01 n/K.

The threshold electric sensitivity -170 mA.

Electricitate antioxidant used Mexidol.

Survey data after treatment.

Threshold electrical sensitivity - 180 ľa.

Electrical lability - 36 Hz.

Visual acuity - 0.6 n/K.

The vitreous body is significantly brighter, remains the case in the lower sections of the eye.

Example 3.

Patient M., aged 71 years, AMB. map 108189.

Diagnosis: recurrent hemophthalmus, proliferative diabetic retinopathy, artiphakia, secondary glaucoma OD terminal glaucoma OS. The patient repeatedly treated (history of vitrectomy, several traditional courses of treatment) without effect, the vision was not restored.

Survey data.

Vis OD - pr. certa (correct projection light).

Threshold electrical sensitivity - 280 ľa.

Electrical lability - 39 Hz.

The patient, in the conditions of example 1 spent on treatment for 10 days.

Survey data after treatment.

Vis OD - 0,08 n/K.

Threshold electrical sensitivity - 190 ľa.

Electrical lability - 36 Hz.

One month after treatment Vis OD=0,4 n/K.

Thus, the result is degenova treatment of hemophthalmia.

Example 4.

Patient T., aged 36 years. AMB. map 106282.

Diagnosis: post-traumatic hemophthalmus OD.

Survey data.

Vis OD-0,08 n/K.

EPE: threshold electrical sensitivity - 160 ľa.

Electrical lability - 26 Hz.

The patient completed the treatment by the proposed method under the conditions of example 1.

After the treatment.

Vis OD=0,2-2,0 D=0,25.

After 3 months. Vis OD=0,125 with correction = 0,6.

Threshold electrical sensitivity - 120 ľa.

Electrical lability - 31 Hz.

As a result of treatment the patient has significantly improved visual acuity, vitreous body lit up.

All positive results by the proposed method treated 52 patients.

1. Method of conservative treatment of hemophthalmia various origins, involving the integrated use of pharmaco - and magnetotherapy, characterized in that the retro-bulbar space two times a day injected sequentially at intervals of 30 min, drugs from groups: anticoagulants, corticosteroids, antioxidants and angioprotectors, and between the morning and evening stages of the introduction is from 4 to 20, tension 12-15 MT and a frequency of 50 Hz, the course of treatment is 10 days.

2. The method according to p. 1, characterized in that the drugs injected into the retro-bulbar space through previously implanted catheter.

 

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