Method for influencing aqueous humor discharge in the cases of primary open angle glaucoma

FIELD: medicine.

SUBSTANCE: method involves introducing hypotensive means by means of instillations. Eye drops of emoxipin are instilled 20-30 min later twice a day during 4-8 weeks. The treatment course is repeated in 2-3 months.

EFFECT: improved vision function; normalized hemodynamic values.

1 tbl

 

The invention relates to medicine, particularly ophthalmology, and can be used for medical treatment of patients with primary open-angle glaucoma.

Object of the invention is to increase the ease of intraocular fluid and improve the field of view in the initial or advanced stages of glaucoma.

The closest analogue of the proposed method is a method comprising introducing into the eyes of taurine (taufona) for the treatment of glaucoma, followed by the introduction antiadrainergicakimi means to reduce the retention of watery mist (SU # 1648452, from January 15, 1991). However, when using this method is not achieved improvements of visual functions, in particular the expansion of the field of view.

The technical result of the invention is a reliable increase in the coefficient ease of movement and positive dynamics of the field of vision in patients with primary open-angle glaucoma after introduction into the eyes of emoxipin with prior instillation antihypertensives (antiadrainergicakimi or combined drug and inhibitor of carbonic anhydrase).

It is known that the metabolic processes in the physical conditions are accompanied by the formation of reactive oxygen species or free radicals that initiate lipid peroxidation (LPO). The specified process is m resist antioxidants. A prerequisite for application of antioxidants in glaucoma based on the data on the accumulation of LPO products in the aqueous moisture and tissues of the drainage area of the sclera glaucomatous eyes (Bunin YA and About the other part of the process of lipid peroxidation in the destruction of the drainage system of the eye in open-angle glaucoma. West. oftalmol. 1985, No. 2, s-16). Aqueous humor gives life to the avascular structures of the eye, participating in the metabolism of contacting tissues. It is known that increased level of LPO products in the aqueous moisture can have a cytotoxic effect on the structures of the eye, washed this moisture, in particular drainage system, which increases the resistance to aqueous outflow.

Thus, in contrast to the nearest analogue, using the proposed method for increasing aqueous outflow is achieved by the combination of emoxipin not only with antiadrainergicakimi drugs, but also with other classes of antihypertensive drugs (inhibitors carbonhydrate) and some combined eye forms (praxitelean), in addition, simultaneously with the improvement of hydrodynamics eyes of patients with glaucoma have seen positive changes in function of the eye, which was not observed in the appointment of practolol with taufona.

The technical result is achieved due to the combined p is imeneniya emoxipin and local antihypertensives (practolol, timolol maleate of prokarelia, trusopta) in certain modes of obtaining accumulation effect. The treatment of patients with primary open angle glaucoma and retention watery moisture in the background instillation antiadrainergicakimi agents, carbonic anhydrase inhibitors or their combined purpose, as well as a combined preparation (praxitelean). It is the combination of anti-hypertensive drug and emoxipin allows to achieve normalization of hydrodynamics and improvement of visual functions.

The method is as follows. The emoxipin in the form of eye drops instilliruut eyes within 4-8 weeks, 1 drop twice a day 20-30 minutes after administration of one of the above anti-hypertensive drugs. The effect of increasing the coefficient ease of movement on average 50-60% was noted after 1 or 2 months after starting treatment with the gradual increase of the effect. In parallel with the increase in the outflow note a slight decrease IOP and significant (reliable p<0.001) reduction factor Becker. Tonometry was held applanation tonometer Maklakov, topography - in the domestic e-monografie GTG-01. All patients were examined using conventional glaucoma ophthalmic techniques (the study of visual acuity and fields of vision, ophthalmoscopy, biomicro the Pius, gonioscopy).

Data on the status of IOP, hydrodynamics and function of the eye in patients with glaucoma in the treatment of hypotensive and after combined local installations add to them emoxipin presented in the table.

N
Indicators n*ex.1 montht2 months.t**
IOP21,4±0,2720,8±0,211,6320,6±0,22,08
Ro16,2±0,3915,4±0,321,5015,1±0,35to 2.06
0,16±0,0070,24±0,016,60,26±0,018,0
F 311,0±0,061,3±0,122,581,3±0,122,85
KB107±5,6968±was 2.766,162±2,87,03
Visus0,7±0,060,7±0,06-0,7±0,06-
FP457±4,9471±4,62,18479±4,63,3
CPS     
90,7±,55--96,4±1,44to 2.67
Scotomas 1 day.6,2±0,78--2,6±0,48a 3.9
Scotomas 2 then. 301,7±0,40--0,8±0,331,69
Of the score. Scotomas.3.3V±0,58--2,0±3,71,98
* n is the number of eyes

** t - in relation to the initial level

Thus, as can be seen from the table, the introduction in the eyes of the patient solution emoxipin 20-30 min after local antihypertensives leads to a significant increase outflow of aqueous humor (50-60%), increased peripheral boundaries of the field of view and reducing the number of cattle.

Examples of the complete method.

Example 1. Patient 3., 72 years old, a/C No. 3149. Was admitted with a diagnosis of OS - 11V, glaucoma. Field of view (for a total of 8 meridians) OD - 425°, OS - 430°.

Data static perimetric studies:

 ODOS
Norma8681
Scotomas 1 order915
Scotomas 2 order43
Absolute. scotomas44

Installation practolol 1% twice a day reduced the IOP of both eyes 22 and 23 mm Hg, but the rate of hydrodynamics remained abnormal.

OD:Ro=18,86;C=0,12;F=1,06:KB=157
OS:Ro=13,35;C=0,11;F=0,37;KB=121

Adding to practolol double instillation emoxipin 1% twice a day caused a positive state of the field of view, slightly reduced IOP, increased outflow of aqueous humor and reduced the coefficient of Becker.

Listed below are the state data field of vision and indicators of hydrodynamics in 1 and 2 months after the start of co-instillation of practolol with emoxipin.

Field of view (for a total of 8 meridians) through 1 month - OD - 440°; OS - 450°, 2 months - OD - 455°, OS - 450°

Data static perimetric studies:

 After 1 monthAfter 2 months
 ODOSODOS
Norma9189 9593
Scotomas 1 order6946
Scotomas 2 order3221
Absolute. Scotomas3323

These monografii after 1 month

OD:Po=15,88;S=0,16;F=0,95:KB=99;
OS:Po=of 14.57;C=0,20;F=0,91;KB=73;

These monografii after 2 months

OD:Ro=15,88;C=0,21;F=1,21:KB=75
OS:Ro=of 14.57;C=0,24;F=1,10;KB=61

Thus, the combined purpose of practolol with emoxipin within two months of expanded peripheral border of the field of view, reduced the number of cattle, normalized indicators hydrodynamics of the eye. Noteworthy that after 2 months of treatment, positive dynamics of the above indicators are more pronounced than 1 month.

Example 2. Patient L., 73, No. 5864. Was admitted with a diagnosis of OS 11 in the glaucoma of the left eye;operated 11 and glaucoma of the right eye. Field of view (for a total of 8 meridians) OS - 435°.

Data static perimetric studies OS.

 OS
Norma87
Scotomas 1 order5
Scotomas 2 order1
Absolute. scotomas10

Installation trusopta 2% twice a day in the left eye decreased IOP to 21 mm Hg, but the rate of hydrodynamics remained abnormal.

OS: Rho=15,88; C=0,12; F=0,68; KB=132

Adding to the trusopta double instillation emoxipin 1% twice a day caused the positive dynamics of the field of view, slightly reduced IOP, doubled the outflow of aqueous humor, normalized coefficient Becker.

Listed below are the state data field of vision and indicators of hydrodynamics in 2 months after the start of co-instillation trusopta + emoxipin. Field of view (for a total of 8 meridians) through 1 month - OS-455°, 2 months - OS - 465°.

Data static perimetric studies OS:

After 1 monthAfter 2 months
 OSOS
Norma9296
Scotomas 1 order31
Scotomas 2 order10
Absolute. scotomas76

These monografii OS after 1 month:

Ro=of 14.57;C=0,24;F=1,10;KB=61.

These monografii OS after 2 months:

Ro=13,35;C=0,33;F=1,4;KB=44.

Thus, adding to the trusopta emoxipin within two months of expanded peripheral field of vision, reduced the number of cattle, normalized indicators hydrodynamics of the eye. Positive dynamics of the above indicators are more pronounced with increasing duration of treatment

Example 3. B-e P, 62 years old, a/C No. 4854. Was admitted with a diagnosis of OS 1 in glaucoma of the right eye; the suspected glaucoma of the left eye. Field of view (for a total of 8 meridians) OD - 480°.

Data static perimetric studies OD.

 OD
Norma88
Scotomas 1 order13
Scotomas 2 order 1
Absolute. scotomas1

Instillation of artiola of 0.25% twice a day in the right eye decreased IOP to 20 mm Hg, but the rate of hydrodynamics remained abnormal. OD: Rho=14,55; C=0,11; F=0,5; KB=132.

Adding to artikolu two pits emoxipin 1% twice a day caused the positive dynamics of the field of view, did not affect the IOP caused normalization of indicators of hydrodynamics eyes.

Below is data describing the state of the field of vision and indicators of hydrodynamics in two months after adding instillation emoxipin to artikolu.

Field of view (for a total of 8 meridians) OD - 475°.

Data static perimetric studies OD.



OD
Norma99
Scotomas 1 order2
Scotomas 2 order1
Absolute. scotomas1
IOP OD=20 mm RT. Art. 

Data topography OD: Rho=15,88; C=0,26; F=1,53; KB=61.

Thus, adding instillation emoxipin to artikolu within two months as from previous patients, expanded peripheral field of vision, reduced the number of cattle, more than twice what Felicia outflow of aqueous humor, more than twice normalized ratio Becker.

Example 4. B-Neu W, 54 years old, a/C No. 8352. Was admitted with a diagnosis of OS 1B glaucoma in both eyes. Field of view (for a total of 8 meridians) OD - 470°, OS - 480°.

Data static perimetric studies:

 ODOS
Norma9495
Scotomas 1 order87
Scotomas 2 order00
Absolute. scotomas11

Instillation of prokarelia (a combination drug consisting of practolol 1% and clonidine 0,25%) lowered IOP to 22 and 23 mm RT. century, however, the results of hydrodynamics eyes remained abnormal.

OD:Ro=20,55;C=0,13;F=1,37:KB=158
OS:Ro=18,86;C=0,17;F=1,51;KB=110

Below are the results that characterize the state of the field of vision and indicators of hydrodynamics eyes two months after adding to proksofelin instillation emoxipin 1% twice a day.

Field of view (for a total of 8 meridians) OD - 495°, OS - 495°.

The data is static the Russian perimetric studies:

 ODOS
Norma10099
Scotomas 1 order13
Scotomas 2 order00
Absolute. scotomas21

IOP - OD=20 mm Hg OS=19 mm Hg

These monografii

OD:Ro=15,88;C=0,21;F=1,21:KB=75
OS:Ro=12,23;C=0,24;F=0,43;KB=51

Thus, adding to proksofelin double instillation emoxipin 1%, twice daily caused a decrease in the number of cattle, increased peripheral boundaries of the field of view, a slight lowering of intraocular pressure, normalization of indicators of hydrodynamics eyes.

Therefore, the proposed method combined use emoxipin with antiadrainergicakimi means (timolol maleate, practolol) a carbonic anhydrase inhibitor (trusopta) and combination drug - praxitelean (consisting of β1,2α1- Grenoble atora and α 2- adrenostimulator) for treatment of patients with POAG allows to achieve the following positive result from the use of the present invention.

1. The application of the present invention is greater peripheral boundaries of the field of view and reduce the number of cattle in most patients with primary open-angle glaucoma.

2. The application of the present invention can significantly increase the outflow of aqueous humor in patients with primary open-coal glaucoma.

3. Effect of combined application of emoxipin with practolol, arotinolol, trusopta and proxophelinum not accompanied by the development of additional negative adverse reactions of the eyes and body in General.

4. Compared to the prototype, the use of these combinations of drugs leads not only to increased aqueous outflow, but also to the positive dynamics of the functions of the eye.

The way to influence the outflow of the aqueous humor of patients with primary open-angle glaucoma, characterized in that the first administered by instillation of anti-hypertensive agent, and after 20-30 min - eye-drops emoxipin twice a day for 4-8 weeks, 2-3 months, repeat the treatment.



 

Same patents:
The invention relates to medicine, namely to ophthalmology, and is intended for the treatment of inflammatory processes in the eyeball

The invention relates to the field of medicine

The invention relates to medicine, in particular to ophthalmology

The invention relates to medicine, in particular to ophthalmology

The invention relates to pharmaceutical industry and relates to pharmaceutical compositions containing 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylic acid or 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylate, to prevent, treatment or inhibition of the development of a simple retinopathy or preproliferative retinopathy; the method of preventing, treating or inhibiting the development of a simple retinopathy or preproliferative retinopathy; and applying the 2-ethoxy-1-[[2'-(1 N-tetrazol-5-yl)biphenyl-4-yl]methyl]benzimidazole-7-carboxylic acid or 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]the benzimidazole-7-carboxylate
The invention relates to ophthalmology and is intended for the treatment of dry eye syndrome (DES) after suffering ophthalmopathy, as well as for treatment of SHBG other etiology
The invention relates to medicine, namely to ophthalmology, and can be used in the operations
The invention relates to medicine, ophthalmology

The invention relates to medicine, namely to the pharmacy and is used for treatment of keratitis and conjunctivitis

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

The invention relates to medicine, namely to ophthalmology

The invention relates to medicine, in particular to ophthalmology, and is intended to prevent apoptosis of ganglion cells in patients with primary glaucoma with normal intraocular pressure

The invention relates to ophthalmology and is intended for the correction of myopic astigmatism

The invention relates to ophthalmology and is intended for the correction of hyperopic astigmatism

The invention relates to ophthalmology and is intended for the correction of mixed astigmatism

The invention relates to ophthalmology and is intended for the correction of ametropia

FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

Up!