A method for the treatment of edematous maculopathy

 

The invention relates to medicine, namely to ophthalmology, and for the treatment of edematous maculopathy. Assign intravenously poliom 200 ml once daily for 3 days. The method allows to increase efficiency, reduce time and reduce treatment side effects. table 4.

The invention relates to medicine, specifically to ophthalmology, and relates to methods of treating edema maculopathy.

Known methods of medical treatment swollen maculopathy with the use of acetazolamide, steroidal and non-steroidal anti-inflammatory drugs [1-8].

The closest (prototype) is a method of treating edema maculopathy by assigning medicines - acetazolamide, which belongs to the group of diuretics and can reduce swelling by increasing fluid absorption pigment epithelium of the retina [1].

However, this method has the following disadvantages: 1. The duration of treatment with acetazolamide should be at least 3-4 weeks [1, 2]; for less time (2 weeks) after stopping treatment eyesight deteriorates again [2, 8].

2. In some cases, swelling may persist despite ongoing therapy [1].

3. Protiva arnosti-inflammatory effect of the drug is not large enough [5, 7].

5. The drug is effective only to the maximum therapeutic dose of 500 mg of [4, 6] , the purpose of which develop side effects, in particular hypokalemia [9].

The objective of the invention is to increase efficiency, reduce cycle time and reducing side effects of treatment swollen maculopathy.

This object is achieved by assigning intravenous polyoma 200 ml once daily for 3 days.

The drug poliom represents a 30% solution of polyethylene oxide 400 for intravenous and belongs to the group of osmotic diuretics [10, 11] .

Use polyoma for the treatment of edematous maculopathy are not described in literature.

Brand new in the present invention is that according to the method for the treatment of edematous maculopathy injected polyoma 200 ml once daily for 3 days. Course intravenous polyoma leads to the disappearance of edema of the corneal endothelium, reduction of the size of the Central scotoma and trends to improve visual acuity. This property is not explicitly derived for the expert from the prior art.

This method is passed clinical trials, Department of eye diseases Setstat criteria of the invention: "new", "inventive step", "industrially applicable".

The proposed method is as follows. Patients with edema maculopathy injected polyoma 200 ml once daily for 3 days. Single and double introduction polyoma not give the desired result.

The results of therapy polyoma at single and double intravenous injection in patients with edema maculopathy presented in tables 1 and 2.

Example 1 the Study was performed on 10 patients (group 1) with a diagnosis of swollen maculopathy. All the patients revealed swelling of the endothelium of the cornea at the limbus, Central retinal edema, marked reduction in visual acuity and Central scotoma; intraocular pressure was within normal limits. Poliom was injected intravenously in a volume of 200 ml in a single dose. On the first day after injection polyoma was observed weak (10%, P>0.05) reduction of intraocular pressure and the tendency to reduce the size of the Central scotoma without changing the severity of the swelling of the endothelium of the cornea at the limbus and Central retinal edema.

Example 2 the Study was performed on 10 patients (group 2) with a diagnosis of swollen maculopathy. All the patients revealed swelling of the endothelium of the cornea at the limbus, bylo within normal limits. Poliom was injected intravenously in a volume of 200 ml twice; re-infusion was made the day after the first. A day after re-introduction polyoma was observed weak (10%, P>0.05) reduction in intraocular pressure, weak (20%, P>0.05) increase in visual acuity. The size of the Central scotoma decreased significantly more than in 2 times; the severity change indicator was significantly different from the values in group 1. A decrease in the swelling of the endothelial cells in the limbus without changing the Central retinal edema.

The results of therapy Polycom in three days (course) intravenous injection in patients with edema maculopathy presented in table 3.

Example 3 the Study was performed on 10 patients (group 3) with a diagnosis of swollen maculopathy. All the patients revealed swelling of the endothelium of the cornea at the limbus, Central retinal edema, marked reduction in visual acuity and Central scotoma; intraocular pressure was within normal limits. Poliom was injected intravenously in a volume of 200 ml once daily for three days. A day after the last injection polyoma has been poor (11%, P>0.05) reduction in intraocular pressure, moderate (33%, P>0.05) increase in the severity of La was significantly different from the values in groups 1 and 2. If isometrie noted a significant increase in visual acuity (43%). Observed the disappearance of the swelling of the endothelial cells in the limbus and reducing retinal edema.

Thus, in patients with edema maculopathy anti-edema effect polyoma develops during the course (three) the use of the drug.

A specific example of the process the Patient W., 41, was admitted to the Department of eye diseases, hospital of clinics of the Siberian medical University 16.02.2001 with a diagnosis of peripheral uveitis, Central maculopathy (history 685/285).

Treatment: intravenous polyoma 200 ml once daily for 3 days starting from the date of admission to the hospital.

Dynamics of indicators presented in table 4.

Table 4 shows that the drug has a weak influence on the intraocular pressure, the value of which the original was normal. According to biomicroscopy and original, and at different periods of observation the condition of the anterior segment of the eye according to biomicroscopy was unchanged. In the fundus was revealed edematous maculopathy due to peripheral uveitis. In the treatment of polyoma swelling weakened and after a three-day course edema liquidity the increase in visual acuity by 50% and then 2 times. The size of the Central scotoma was the original 5odid not change after the first infusion was decreased to 3oafter the second infusion. After the third infusion polyoma field of vision became normal and remained until discharge of the patient. After the course introduction polyoma hypokalemia is not revealed.

The present invention has a higher positive effect in comparison with the prototype, namely anti-edema effect is achieved in 100% of patients duration of treatment is 3 days. Long-term recurrence rate is not observed. Side effect in the form of hypokalemia is missing.

Sources of information 1. Explains T. J., Herbrt C. P. Treatment of cystoid macular edema with non-steroidal anti-inflammatory drugs and corticosteroids // Doc. Ophthalmol. - 1999. - Vol. 97, 3-4. - P. 381-386.

2. Tripathi R. C., Fekrat S, Tripathi B. J., Ernest J. T. A direct correlation of the resolution of pseudophakic cystoid macular edema with acetazolamide therapy // Ann. Ophthalmol. -1991. - Vol. 23, 4. - P. 127-129.

3. Moldow C., Sander C., Larsen, M., Engler, S., Li C., Rosenberg T., Lund-Andersen H. The effect of acetazolamide on passive and active transport of fluorescein across the blood-retina barrier in retinitis pigmentosa complicated by macular oedema // Graefes. Arch. Clin. Exp. Ophthalmol. - 1998. - Vol. 236, 12.-P. 881-889.

4. Fishman, G. A., Gilbert L. D., Fiscella R. G., A. Kimura E, L. M. Jampol Acetazolamide for treatment of chronic macular edema in retinitis pigmentosa // Arch. Ophthalmol. - 1989. - Vol. 107, 10. -P. 1445-1452.

5. Whitcup, S. M. , K. G. Csaky, Podgor, M. J., Chew, E. Y., C. H. Perry Nussenblatt RB A randomized, masked, cross-over trial of ace dominant cystoid macular dystrophy. A pilot study // Ophthalmic. Paediatr. Genet. - 1993. - Vol. 14, 2. - P. 95-99.

7. SOH, S. N., Hay, E., Bird, A. C. Treatment of chronic macular edema with acetazolamide //Arch. Ophthalmol. - 1988, Vol. 106, 9. - P. 1190-1195.

8. Schilling H., Pauleikhoff D., Schrenk M., Wessing A. Therapie zystoider und diffuser Makulaodeme nach Uveitis und Katarakt-Chirurgie mit dem Carbo-anhydrase-Hemmer Acetazolamid (Diamox) // Klin. Monatsbl. Augenheilkd. - 1993. - Bd. 202, 3. - S. 206-211.

9. Mashkovsky M. D. Medicines. - Kharkov: Torching. Ed. 13. -T. 1.-S. 490.

10. Carpenter, M. B., fungal Century. And., Chernyshev, A. Effect of intravenous infusion of the drug poliom on diuresis, indicators of systemic and cerebral hemodynamics // bul. the experimental. Biol. and the honey. - 1997. - T. 123, 3.-S. 299-301.

11. Fungal Century. And. Diuretic and anti-edematous properties polyoma // abstract. dis. Kida. Biol. Sciences. - Tomsk, 1998. - 24 S.

Claims

A method for the treatment of edematous maculopathy, which is to assign drug therapy, characterized in that it is administered intravenously poliom 200 ml once daily for 3 days.

 

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