Method of treating optic atrophy in children of age from 1 to 6 months

FIELD: medicine.

SUBSTANCE: invention relates to medicine, ophthalmology, and can be used for treatment of optic atrophy in children of age from 1 to 6 months. For this purpose regions of large and small fontanelles of head and upper sympathetic ganglia at the level of cervical spine at C1-C2 level are exposed to polarised light of apparatus "Bioptron". Exposures to light are carried out daily during 10 days in therapeutic dose 12 J/cm2 from the distance 5 cm from skin surface with light spot diametre 5 cm, irradiation intensity 40 mW/cm2 exposure duration 30 seconds on region of fontanelles and 1 minute on regions of ganglia. On finishing light impact nootropic medications cortexin and/or actovegin or cerebrolisin are introduced in age dose. Courses of treatment are carried out from 1 month to 6 month age until desired therapeutic effect is obtained.

EFFECT: method allows to improve cerebral and intraocular blood supply and metabolic processes of brain and optic nerve, improve delivery of nootropic medications to optic analyser, obtain therapeutic concentrations of medications without side effects.

1 tbl, 1 ex

 

The invention relates to medicine, namely to ophthalmology, and can be used for treatment of optic nerve atrophy (OPA) in children from 1 to 6 months.

OPA is one of the main causes of childhood blindness and eye disability. Regardless of the causes of OPA in the basis of disease is a circulatory and tissue hypoxia due to impaired capillaroscopic ensure tissue of the optic nerve (MN).

There are various methods for correction of capillary blood flow in AZN, for example the use of vasoactive drugs such as reverse, nicotinic acid, pentoxifylline, galidor. In the treatment of AZN used as nootropic agents - Cerebrolysin, Cortexin; antioxidants and antihypoxants (Mosin IM Disease of the visual pathways in early childhood: etiology, clinical manifestations, topical and differential diagnosis, aspects of rehabilitation. Abstract. dis. dokra honey. Sciences. M - 2002). However, with the depletion of cerebral and ocular blood flow does not provide adequate delivery of essential drugs to the Central and peripheral parts of the visual analyzer in the required therapeutic concentration.

Known methods of stimulation of capillary blood flow and, consequently, the creation of the necessary therapeutic to the of ncentrate nootropic funds in Central and peripheral parts of the visual analyzer physiotherapeutic means: by lit fundus low-intensity helium-neon laser (GNL), using DC or AC electric and magnetic currents.

A common shortcoming of these treatments is the inability to perform quality lit of the fundus due to the lack of infants with the condition of fixation of the eye and due to the narrow and rigid pupil; contraindications to electrical and magnetic therapy, especially when concomitant neurological disease that usually manifests itself in children with perinatal pathology manifestations of hyperexcitability, increased intracranial pressure, tendency to convulsive States. There are age restrictions in performing magnetic and some elettrostimolatori treatment methods.

The closest analogue is the prototype of the invention is retrogressive blood irradiation by the laser (CROCK), used for the treatment of perinatal pathology of the nervous system in newborns (Patent for invention №2152234, 07.10.2000). Irradiated blood by radiation from a He-Ne laser RIP - 1M in big spring above the upper sagittal sinus. Wavelength 6,63 μm. The fiber is applied perpendicular to the skin surface. The exposure time is 60 seconds. Power at the end of the optical fiber of 2.5 mW. Irradiated daily from 4-5 days of life, for 7-10 days. On the second month of life repeat for 1-1,5 minutes, daily for 7-10 days. Power is here to 2.5 mW. The method can improve brain and, indirectly, the capillary blood flow of the eye.

The disadvantages of this method are:

possible mutagenic effects due to irradiation of He-Ne laser;

- the possibility of increased ischemia and hypoxic condition of the brain and provoke the development of seizures due to sympatholytic the direction of the impact of the He-Ne laser;

under the influence of laser radiation, in any way impact may cause photochemical swelling in the neurons of the retina, brain and remote degenerative changes;

- treatment of a he-Ne laser can be performed only in hospitals under the direct supervision of a physician and after special training of health workers.

The objective is to propose a way of influencing the blood flow in children aged 1 to 6 months to ensure therapeutic concentrations of drugs.

The technical result - improvement of cerebral and ocular blood flow by exposure light beam device "BIOPTRON".

Unlike laser beam having a very narrow spectrum of monochromatic light having a high intensity light beam "BIOPTRON" has a broad spectrum polychromatic light and less intensity. Devices "BIOPTRON" radiate l is nano polarized low-energy light with a wavelength of 400-2000 nm. The intensity of the light radiation device "BIOPTRON" is 40 mW/cm2.The depth of the impact under the skin up to 2-5 see

Light "BIOPTRON" able to restore the homeostatic functions of the brain, neuroendocrine glands, to synchronize the biorhythms of the whole organism, and in particular the visual analyzer. This, in turn, leads to activation of microcirculation, promotes the accumulation of drugs in the lesion and improves metabolic processes in the tissues of the eye.

The technical result is achieved by the fact that every day in 4 points: the area is large, small streams and the upper region of the sympathetic ganglia of the left and right of the cervical spine at the level of C1-C2 device "BIOPTRON" are lit in a therapeutic dose of 12 j/cm2diameter of the light beam 5 cm from a distance of 5 cm from the skin surface within 10 days. Exposure time: 30 seconds on the area of the fontanelles and 1 minute on the area of the ganglia. The lit conducted simultaneously with medical treatment: immediately after light exposure in the age dosage administered nootropic agents: Cortexin and/or Actovegin or Cerebrolysin. Treatments after the child's birth each month from 1 month to 6 months of age to obtain the desired therapeutic effect.

When the recommended mode of treatment is in the neurons of the brain and optic nerve by improving capillary blood flow creates a total dose of drugs, which has the effect without adverse reactions. Capillary intraocular blood flow dynamics before and after the treatment is monitored by measuring the rate of flow (PM) using laser Doppler flowmetry (LDF) analyzer LACC-02 (Russia).

Advantages of the method:

- creating the necessary therapeutic concentrations of nootropics in axona and neurons of the peripheral and Central parts of the visual analyzer by improving capillary blood flow by glare device "BIOPTRON";

- the absence of neurological, physical and ophthalmic contraindications to treatment;

the absence of mutagenic effects of radiation lamp "BIOPTRON";

radiation does not cause the development of photochemical swelling of neurons in the brain and retina, as the radiation is linearly polarized energy;

process glare is contactless and sterile;

- the procedure is simple in technical execution, so it can be done at home, which is convenient for parents and reduces the burden on hospitals.

The main and control groups were children with the same degree of decline of visual functions. In both groups of children received the same neuroprotective therapy. In the main group before the introduction of neuroprotective drugs was also conducted session the light therapy device "BIOPTRON".

In the main group under observation there were 13 children aged 1 to 5 months with no behavioral visual reactions, typical for this age. Half of them aged 3-5 months ophthalmoscopically was visualized signs AZN: decolorize of the optic nerve (optic nerve disc) by giocaresale, narrowing of the blood vessels.

The objective criterion of effectiveness of the treatment was to study the rate of intracranial hemodynamics using laser Doppler flowmetry (LDF) analyzer LACC-02 (Russia). Before treatment revealed a decrease in the flow (PM) 33.6-36,9 perfusion units at the rate of 65.0 perfusion units and more.

The children received 1-3 course lit instrument "BIOPTRON" together with neuroprotective therapy. After the 1st course of treatment in 5 (38.4 per cent) children of reaction tracking, stable fixation of the eyes. After the 2nd course of further improvement of vision was observed in 8 children (61,5%). After the 3rd treatment in all treated children raising the subject of vision was accompanied by an improvement of the picture of the fundus in a reduction of declaratii, moderate expansion of vessels of the optic nerve disc. At the end of the 3rd course of treatment using laser Doppler flowmetry (LDF) analyzer LACC-02 (Russia) increased 1.5-2 times the rate of ocular microcirculation: PM to 51,070,2 perfusion units.

The control group consisted of 10 children. After 2-3 courses of treatment behavioral visual reaction, is age-appropriate, registered only in 57% of cases (6 children). The 4-h children's behavioral responses without significant change. LDF performed after the 3rd treatment, showed increased intraocular PM to 38.2-42,5 perfusion units against 33,1-36,5 of perf. units before treatment - see table.

In the study group before treatment when examining ocular hemodynamics using laser Doppler flowmetry (LDF) analyzer LACC-02 (Russia) revealed a decrease in the flow (PM) 33.6-36,9 perfusion units respectively at the rate of 65.0 perfusion units and more. At the end of the 3rd course of treatment was increased 1.5-2 times the rate of ocular microcirculation: PM to 51,0-70,2 perfusion units.

In the control group LDF performed after the 3rd treatment, showed increased intraocular PM to 38.2-42,5 perfusion units against 33,1-36,5 of perf. units before treatment.

Example. Child S., 2 months. When handling complaints about the lack of fixation of the eyes, nystagmoid eye movements. In the ophthalmic examination: in the fundus of both eyes large decolorize the optic nerve disc, a significant narrowing of the blood vessels of the ocular fundus. Eye of the PM measured by LDF, with 32.5 of perf. unit diagnosed with Congenital partial AZN both eyes hypoxic - ischemic Genesis; hypoxic-ischemic encephalopathy.

At the age of 1 month 10-day course of neuroprotective therapy. At the end of treatment appeared unstable fixation of the eyes, the amplitude of nystagmus without dynamics. With 2 months of age neuroprotective therapy was supplemented by carrying out 1 time per month treatment device "BIOPTRON" scheme: lit large and small streams in 30 seconds, lit sympathetic ganglia on both sides of the cervical spine at the level of C1-C2 exposure for 1 minute. Each treatment lasted 10 days. Just spent 3 courses of treatment.

After treatment, at 6 months of age decreased the amplitude of nystagmus appeared stable fixation of the eyes, pronounced response tracking object vision according to electrophysiological studies of visually evoked potentials (SGP) is consistent with the age norm. In the fundus increased colorest the optic nerve disc to the variant rules. Indicators LDF testified PM increase intraocular blood flow to 62.5 perf. units

Table
The dynamics of ocular PM
GroupIndicator eye mi is agamogenetic (PM) (perf. unit)
Before the treatmentAfter the treatment
Main (13 persons) (+ "BIOPTRON")33,6-36,951,0-to 70.2
Control (10 persons)33,1 of 36.538,2-42,5

A method for the treatment of optic nerve atrophy in children aged 1 to 6 months, including the use of nootropic funds and the impact of the light on the area of the springs and the top of the sympathetic ganglia, characterized in that before the introduction of nootropic funds carry out light exposure in the field of large and small streams of the head and the top of the sympathetic ganglia at the level of the cervical spine at the level of C1-C2 polarized light device "BIOPTRON", lit spend daily for 10 days in a therapeutic dose of 12 j/cm2from a distance of 5 cm from the skin surface, the diameter of the light spot 5 cm, the radiation intensity is 40 mW/cm2, exposure time: 30 sec per area fontanelles and 1 min at area ganglia, after light exposure in the age dosage administered nootropic agents: Cortexin and/or Actovegin or Cerebrolysin, treatments with 1 month to 6 months of age before receiving the necessary medical e the reaction.



 

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