Method for treating amblyopia

FIELD: medicine, ophthalmology.

SUBSTANCE: the present innovation deals with treating different forms of amblyopia. It is necessary to carry out medicinal correction of neurological disorders in a patient that includes vasoactive preparations, venotonics, nootropes and metabolics. One should conduct electrophoresis of spasmolytics onto area of jugular vertebral department at current power being 0.5-1.0 mA/sq. cm per 10 min, daily. Simultaneously,, it is necessary to carry out argon-laser stimulation of retinal central area and projection of papillo-macular bundle, about 150-200 impulses/seance, radiation power being 0.05 W, radiation diameter of 1000 mc, exposure time of 0.01 sec, wave length being 498-514 nm every other day. Therapy course lasts for 10 d. The innovation enables to achieve positive dynamics in treating severe forms of amblyopia, restore visual function and obtain correction of neurological disorders.

EFFECT: higher efficiency of therapy.

4 ex

 

The present invention relates to medicine, namely to ophthalmology, and can be used in the treatment of various forms of amblyopia.

There is a method of treatment of refractive amblyopia by surgical correction, then 2 weeks later conduct stimulation of the Central retina low-energy intermittent emission of a laser pulse with duration of application of 0.5-1.0 seconds, and visual load at close range (see RF Patent № 2161939, 2001).

There is a method of treatment of refractive errors, combined with strabismic amblyopia, which conduct the electrical stimulation pulse current to the nasal and temporal region of the eye. Then irradiate the retina and affect electromagnetic field when closed (see RF Patent № 2146910, 2000).

The closest is a method of treatment of amblyopia by affecting the region of the yellow spot of the laser radiation and for more on the orbital part of the circular muscles of the eye the influence of incoherent radiation: wavelength 860-930 nm, 120 mW and magnetic field 20-45 MT, the wavelength of the laser radiation 890 nm, power 2-10 mW (see RF Patent № 2128092, 1999).

However, the known methods do not allow to achieve positive effects in the treatment of severe forms of amblyopia.

The technical result of the proposed method Leche is of amblyopia is to increase the effectiveness of treatment at the expense of achieving positive effects in the treatment of severe forms of amblyopia, the recovery of visual fixation, correction of neurological disorders.

New to the achievement of the technical result is that provide medical correction of neurological disorders.

New is also that carry out electrophoresis of antispasmodics in the region of the cervical spine at an amperage of 0.5-1.0 mA/cm210 minutes daily.

New is also that spend argon laser stimulation of the Central retina and projections Papillo-macular bundle 150-200 pulses when the output power 0.05 W, diameter of laser radiation 1000 MK, exposure 0.01 seconds, the wavelength 498-514 nm through the day, with the course of treatment is 10 days.

It is noted that in 45% of cases of visual impairment in children is associated with CNS disorders, among etiological factors 64% perinatal (see Avetisov AS Congenital pathology as a cause of blindness and reduced vision in children // proceedings of the IV Congress of ophthalmologists of the USSR. - M., 1913. - Vol.2. - S-405).

The mechanism of action of laser radiation are photochemical reactions associated with resonant absorption of light by biological object. When this occurs, lowering the threshold for receptor sensitivity, increase blood flow, improve microcirculation, increase oxygen uptake by the tissues, activation of metabolicheskikh processes in the retina. Medication and physical therapy correction of neurological disorders helps to enhance the effect of argon laser stimulation. Normalizes the tone extraocular muscles, neck muscles and shoulder girdle, which contributes to the normalization of visual-proprioceptive interaction. This allows you to change the position of the optic axis of the amblyopic eye in the direction of ortopedici. Improvement of metabolic processes in the nervous tissue can improve the transmission of nerve impulses, contributes to a more successful formation of normal retinocortical links. Electrophoresis antispasmodics can cut deficiency symptoms in the pool vertebrobasilar arteries. All this allows to increase the efficiency of treatment of amblyopia.

Comparative analysis of the prototype shows that the proposed method differs in that provide medical correction of neurological disorders, electrophoresis antispasmodics in the region of the cervical spine at an amperage of 0.5-1.0 mA/cm210 minutes daily, and argon laser stimulation of the Central retina and projection papillomacular beam 150-200 pulses when the output power 0.05 W, the diameter of the radiation 1000 MK, exposition 0.01 seconds, the wavelength 498-514 nm through the day, the course of treatment is 10 days, which corresponds to the criterion "novelty".

Novasolar.net features allows you to increase the effectiveness of the treatment, to achieve positive effects in the treatment of severe forms of amblyopia, to restore visual fixation, to provide correction of neurological disorders that meets the criterion of "industrial applicability".

The method is as follows.

All patients receive a complete ophthalmologic examination, including additional identifying the nature of visual fixation and determination of the angle of strabismus. After examination by a neurologist with regard to the neurological status of each patient is prescribed medication correction (vasoactive drugs, venotonic, nootropics, metabolite)and electrophores antispasmodics in the region of the cervical spine. Electrophoresis is conducted according to the methodology: the electrode is soaked in a 1% solution of aminophylline, set at the level of the cervical vertebrae With2-C6; the electrode is soaked in a 0.1% solution of papaverine, set in the region of the handle of the sternum. The current strength of 0.5-1.0 mA/cm2time - 10 minutes. Sessions are conducted daily for 10 days. At the same time all patients undergo an argon laser stimulation. In the treatment using argon laser company HGM. Treatment includes 5 sessions local stimulation of the Central zone of the retina and the projection of Papillo-macular bundle 150-200 pulses, the diameter of laser radiation 1000 MK, power 0.05 W, exposure time of 0.01 s, the length in the us 498-514 nm.

Under supervision there were 40 patients aged 5 to 10 years. Of them: divinatory amblyopia with off-center detent 14, refractive amblyopia II-III degree - 8 people, amblyopia of obscure origin III-IV degree - 7 persons, anisometropic amblyopia II-III - 11. Of the features of the neurological status: 66% pain points in the cervical spine. In 86% of cases were observed pathological neurological symptoms: horizontal nystagmus in 44% of patients, the change of tone - at 46%, the recovery of tendon reflexes - 20%. In 62% of cases had impaired vascular tone, 38% - signs of intracranial hypertension, 12% of patients increased convulsive readiness, 44% awarded cerebral disturbances, 38% is a dysfunction of brainstem structures.

Example 1.

The patient Verzakov L., born in 1993

From the anamnesis: convergent strabismus from birth, repeatedly (4 courses) were treated amblyopia of the left eye under the eye of the branch Road hospital.

In the initial examination in the children's Cabinet IFS of IRTC "eye microsurgery":

visual acuity OD=1,0

OS=0.04 correction sph+3,25=0,05

Autorefractometry OD 0.000.00

OS +4.00 cyl-1.0ax154

CH. bottom: the optic nerve disc pink, clear boundaries. Vessels, peripherals, related macular area - without a pathology. Fixing OD - Central, OS - parameswara.

The angle of strabismus on Girshberg - from 0 to +2 degrees, when coverthese - up to +5.

Diagnosis: Converging friendly monolateral strabismus. Hypermetropia 2 tbsp. OS, complex hyperopic astigmatism OS. Divinatory amblyopia 4 tbsp. with off-center visual fixation OS.

According to the results of neurological examination detected scattered " soft " signs of residual character without signs of local pathology.

The patient underwent a course of treatment in a specified way: against medical treatment, in combination with electrophoresis antispasmodics in the region of the cervical spine, were laser-stimulation of the Central regions of the retina. Medical treatment included rate nootropil inside. Electrophoresis was carried out according to the method of Ratner: the electrode is soaked in a 1% solution of aminophylline, is set at the level of the cervical vertebrae With2-C6; the electrode is soaked in a 0.1% solution of papaverine, is installed in the arm area of the sternum. Current of 0.5 mA/cm2time - 10 minutes. The sessions were conducted daily for 10 days.

Laser stimulation was performed using argon laser company HGM. Treatment consisted of 5 sessions local argon-laser-stimulation of the Central zone of the retina and the projection of Papillo-macular bundle conducted according to standard methods: 150 imp is sow in one session, the diameter of laser radiation 1000 MK, the minimum energy of 0.05 W, exposure time of 0.01 s, the wavelength 498-514 nm. The treatment sessions were conducted every other day.

After the treatment:

visual acuity OD=1,0

OS=0.15 correction sph+3,25=0,3

Fixing OS - Central

The squint angle is 0, the carpet-test - up to +5 degrees.

Example 2.

Bass C., born in 1995

From the anamnesis: in January 2004, manufactured surgical treatment of congenital cataract of the right eye.

Diagnosis: Artiphakia OD. Amblyopia of obscure origin 4 tbsp. OD

Before treatment:

visual acuity OD=0,05 Nicholas

OS=1.0

Autorefractometry OD+0.75 cyl-0.5axl2

OS+1.0 cyl+0.25ax92

The angle of strabismus - 0

The nature of vision - monocular OS

CH. bottom: within normal limits. Fixing OU - Central.

Of the features of the neurological status: syndrome neuro-circulatory failure with signs of moderate difficulty of venous outflow.

The patient received treatment offered by way of: medical treatment, including Actovegin and reverse, electrophoresis antispasmodics in the region of the cervical spine, laser stimulation of the Central regions of the retina.

Electrophoresis was carried out according to the method of Ratner: the electrode is soaked in a 1% solution of aminophylline, is set at the level of the cervical vertebrae With2-C6; the electrode is soaked in a 0.1% solution of papaverine, set the joins in the arm area of the sternum. Current of 1.0 mA/cm2time - 10 minutes. The sessions were conducted daily for 10 days.

Laser stimulation was performed using argon laser company HGM. Treatment consisted of 5 sessions local argon-laser-stimulation of the Central zone of the retina and the projection of Papillo-macular bundle conducted according to standard methods: 200 pulses per session, the diameter of laser radiation 1000 MK, the minimum energy of 0.05 W, exposure time of 0.01 s, the wavelength 498-514 nm. The treatment sessions were conducted every other day.

After treatment:

visual acuity OD=0,25 Nicholas

OS=1.0

The nature of the view up to 3 m - binocular.

Example 3.

The patient Ivanov M., 1997

From the anamnesis: reduced vision revealed 1 year ago, the glasses worn irregularly.

The diagnosis of Strabismus friendly, monolateral, converging with the vertical component of the OS. Hypermetropia 1 tbsp. OU, complex hyperopic astigmatism OS. Amblyopia 4 tbsp. OS with non-Central fixation.

Before treatment:

visual acuity OD=0,6 Nicholas

OS=0,04 Nicholas

Autorefractometry OD+2.25 cyl-Ah

OS+2.25 cyl-0.75axl77

The squint angle is 5 degrees OS. Eye movement is not limited. When you look to the right - OD deviates up to 10 degrees, when you look to the left of the OS up to 10 degrees.

CH. the bottom - without a pathology. Fixing OD - Central, OS - parafoveal.

According to neurological examination found the Jena easy intracranial hypertension, signs of moderate difficulty of venous outflow, sharp asymmetry of pulse blood, signs of vasospasm after rotating the sample, moderate cerebral disorders with increased medlennovolnovoj activity. These changes can be regarded as consequences of Natal CNS lesions.

The patient underwent a course of vasoactive substances (Actovegin, Cavinton), electrophoresis antispasmodics in the region of the cervical spine No. 10, laser stimulation of the Central regions of the retina No. 5.

Electropores was carried out according to the method of Ratner: the electrode is soaked in a 1% solution of aminophylline, is set at the level of the cervical vertebrae C1-C6; the electrode is soaked in a 0.1% solution of papaverine, is installed in the arm area of the sternum. Current of 0.5 mA/cm2time - 10 minutes. The sessions were conducted daily for 10 days.

Laser stimulation was performed using argon laser company HGM. Treatment consisted of 5 sessions local argon-laser-stimulation of the Central zone of the retina and the projection of Papillo-macular bundle conducted according to standard methods: 150 pulses per session, the diameter of laser radiation 1000 MK, the minimum energy of 0.05 W, exposure time of 0.01 s, the wavelength 498-514 nm. The treatment sessions were conducted every other day.

After treatment:

visual acuity OD=1,0

OS=0,2 Nicholas

Hugo is strabismus - 0 degrees, when the carpet-test - to +2, the vertical component - up to +5 degrees.

Fixing OU - Central.

Example 4.

The patient Mokhov I., born in 1992

From the anamnesis: constant wearing of glasses with 4 years of age, courses pleoptic treatment in special conditions. group of kindergarten for 3 years.

Diagnosis: Hypermetropia 3 tbsp. OU. Refractive amblyopia 2 tbsp. OU.

Before treatment:

visual acuity OD=0.05 s q+4,0=0,3

OS=0.05 s q+4,0=0,3

The squint angle is 0.

Autorefractometry OD+7.25 cyl-Ah

OS+7.5 cyl-0.75axl79

CH. bottom: without features.

Of the features of the neurological status: signs compensated hydrocephalus, moderate cerebral disorders without signs of local pathology, signs of perinatal CNS damage. The patient underwent a course of medical treatment (Actovegin, pyromellitic), electrophoresis antispasmodics in the region of the cervical spine No. 10, laser stimulation of the Central regions of the retina No. 5. Electropores was carried out according to the method of Ratner: the electrode is soaked in a 1% solution of aminophylline, is set at the level of the cervical vertebrae With2-C6; the electrode is soaked in a 0.1% solution of papaverine, is installed in the arm area of the sternum. Current of 1.0 mA/cm2time - 10 minutes. The sessions were conducted daily for 10 days.

Laser stimulation was performed with IP is the use of the argon laser company HGM. Treatment consisted of 5 sessions local argon-laser-stimulation of the Central zone of the retina and the projection of Papillo-macular bundle conducted according to standard methods: 200 pulses per session, the diameter of laser radiation 1000 MK, the minimum energy of 0.05 W, exposure time of 0.01 s, the wavelength 498-514 nm. The treatment sessions were conducted every other day.

After treatment: visual acuity OD=0.15 Corr.+4,0=0,6

OS=0.15 Corr.+4,0=0,6.

The method of treatment of amblyopia by affecting the Central area of the retina by laser radiation, characterized in that provide medical correction of neurological disorders, including vasoactive drugs, venotonic, nootropics and metabolite, electrophoresis antispasmodics in the region of the cervical spine at an amperage of 0.5-1.0 mA/cm210 minutes each day, while conducting an argon laser stimulation of the Central retina and projections Papillo-macular bundle 150-200 pulses, when the radiation power of 0.05 W, the diameter of the radiation 1000 MK, exposure 0.01 seconds, the wavelength 498-514 nm through the day, with the course of treatment is 10 days.



 

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4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

The invention relates to medicine, namely to physiotherapy, and is intended for the rehabilitation of patients in the treatment of fractures of the pelvis

Galvanic comb // 2240840
The invention relates to medicine, namely to prevention devices, and is intended to affect the scalp, stimulation and hair growth

FIELD: medicine, ophthalmology.

SUBSTANCE: the present innovation deals with creating safe and efficient heteroplastic material for treating progressing myopia, stabilization of dry maculodystrophy and manufacturing antiglaucomatous drainages at maximal decrease of antigenic properties and guaranteed sterility of biomaterial that provides the absence of post-operational complications (chemosis, tenonitis, pridocyclitis) at operative therapy of progressing myopia and guarantees stabilization of myopia progressing, the stabilization of pathological processes at dry maculodystrophy, normalization of intra-ocular pressure at operative treatment of glaucoma at applying the drainage out of the material suggested. In the course of the method in question one should treat cattle pericardium after mechanical purification with 10%-ammonia solution for about 4-5 h, washed with distilled water followed by a 4-fold freezing at -10-12° C and defrosting at +40-45° C, for 7.5 h it should be treated with 6%-hydrogen peroxide solution at +15° C, after cutting the material it should be treated with ultrasound to repeat the whole procedure at mixing device, then material should be dehydrated in alcohols of initial concentration ranged 30-70 volumetric percentage to be applied into the vials with 70%-ethanol and sterilized with ionizing radiation at the dosage of 1.5 Mrad.

EFFECT: higher efficiency.

3 ex

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