Method for integrated treatment of age-related macular degeneration

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to ophthalmology. That is ensured by the integrated treatment involving the single macular exposure to a sublimit micro-pulse infrared laser light. That is combined with the ozone therapy using drug preparations with underlying mixed gas agitation. That is followed by an antioxidant therapy consisting of local instillations of emixipin and oral administration of complivit oftalmo.

EFFECT: method enables the therapy of predisciform age-related macular degeneration at the stage of confluent drusens, preventing the development of the disease and improving the visual acuity.

2 ex

 

The invention relates to medicine, in particular to ophthalmology, and it is intended for the treatment of eye disease with laser therapy, ozone therapy and antioxidant therapy.

There is a method of predicting the course of age-related macular degeneration, which determine the parameters of autofluorescence mesh shell. Originally lead round the first circuit area high autofluorescence and measure the area (S1) high autofluorescence mesh shell. Then in 3-6 months lead round the newly formed second circuit area high autofluorescence and measure the area (S2) in this zone. If the area of the second circuit area high autofluorescence in the Central area of the retina (S2) is larger than the area of the first circuit area high autofluorescence (S1), then predict the progression of the degenerative process of the pigment epithelium of the retina (U.S. Pat. No. 2386387 EN. Publ. 20.04.2010).

However, the known method can improve the accuracy of predicting the course of age-related macular degeneration and is not intended to treat predischarge forms of age-related macular degeneration at the stage drain druses.

There is a method of treatment of edematous forms of diabetes makwiramiti offering a comprehensive treatment consisting of limpot the FIPA, through the implementation of the pterygopalatine blockades (CSS) using medicinal mixture and discrete plasmapheresis with in vitro photomodification blood. CBN perform on the side of the affected eye daily rate 6-8 blocks, using a drug mixture containing: lidocaine is 50-100 mg, Cerebro - 250-500 mg, Mexidol is 50-100 mg, the medication of 2.5 - 5 mg, hyaluronidase - 16-32 UNITS. Discrete plasmapheresis is performed in the amount of 3-5 treatments with a time interval of 48-72 hours for the procedure exfuze is not more than 20-25% of circulating blood volume. Reinfusion carry out intravenous drip during reinfused spend ultraviolet blood irradiation (U.S. Pat. No. 2367386 EN).

Known to be used for the treatment of eye diseases, the group of inventions, in particular used for the treatment of age-related macular degeneration, in which it is administered an effective amount of the antibody, which is specific linked with A peptideβ1-40or antibodies, which are specific binds to the epitope on the Aβ1-40andβ1-42. The antibodies allows you to restore retinal function (U.S. Pat. No. 2434639 EN. Publ. 27.11.2011).

However, a well-known group of inventions is not intended for the integrated treatment of age-related changes of the eye using laser therapy, ozone therapy and antioxidant the th therapy.

There is a method of treatment of acute inflammatory diseases of the orbit, which are orbitotomy in one or more quadrants. Conduct traditional intensive therapy using 1% solution of nicotinic acid, 2% of pentoxifylline, hyaluronidase at a dose of 64 DB, Actovegin in a dose of 2 ml and neostigmine 0.05% in a dose of 1 ml, in addition carry out electrophoresis with 0.05% proserin, alternating with 0.5% hydrocortisone emulsion endonasal with set rate number of procedures (U.S. Pat. No. 2435555, EN. Publ. 10.12.2011,).

However, the known method is not suitable for the integrated treatment of age-related changes of the eye using laser therapy, ozone therapy and antioxidant therapy.

There is a method of treatment of anterior ischemic neuropathy of the eye in which conduct the laser infrared transpupillary therapy directly to the optic nerve head, with the wavelength of 810 nm, the radiation power 510-710 mW and a spot diameter of 2.0 mm, exposure time within 1.0 to 1.5 minutes, if necessary, repeat the treatment after 1-2 months (U.S. Pat. No. 2338491 EN. Publ. 20.11.2008).

However, the known method does not provide a comprehensive impact on eye disease including laser therapy, ozone therapy and antioxidant therapy to achieve treatment effectiveness by preventing progressioni the disease and increase visual acuity.

The present invention is the possibility of treating predicciones forms of age-related macular degeneration at the stage drain druses by affecting the macular area infrared laser, receiving ozone therapy and local antioxidative therapy for effective treatment, prevention of disease progression and increase visual acuity.

The problem is solved in that in the method of complex treatment of age-related macular degeneration, including the effects of infrared diode laser 810 nm, the creation of a solid circular spots by location coagulants, individual selection of power exercised by a single impact on the macular area subproposal impulse exposure to an infrared diode, coagulates with a diameter of 1.8 μm in an amount of from 8 to 10 have projected soft drusens around the foveolar area, in addition impose them on each other so that each successive coagulate overlaps the previous 1/8, then the last coagulate put in the center in the area of the fovea, together with ozone therapy, to do this, give intravenous drip of saline solution on the background of ozonation gas mixture, the concentration of ozone at the outlet of the ozonizer is 2500 µg / l, the number of sessions to ten, what each of them carry out for 10-15 minutes, additionally, parallel conduct antioxidative therapy within 3 months by local instillation of emoxipin 1% 1 cap 3 times a day per os komplivit ophthalmic 1 tablet 1 time per day.

The present invention explain the detailed description and clinical examples.

The method of laser treatment drain druses in age-related macular degeneration is as follows.

Before treatment carry out a comprehensive study of the patient. To do this, use the following survey methods:

- visual acuity with a maximum correction;

- ophthalmoscopy lens Reichel Mainstr 1x Retina;

- photographing of the fundus on the fundus camera Kari-Zeis;

- optical coherence tomography;

fluorescence angiography.

After a diagnosis of conduct laser treatment drain druses in age-related macular degeneration. Before treatment the patient local anesthesia, using a 0.4% solution of inakaya. Then carry out subprogamme impulse effect, which is performed using an infrared diode laser 810 nm IRIDEX IQ 810 (USA) with a wide adapter and lenses Reichel Mainstr lx Retina. Using the latter, get a solid circular spot of large diameter.

In all cases, was preferred spot with a diameter of not less than 3.0 mm, the Power p is giraut individually, depending on the degree of pigmentation of the fundus based on the test results. Test coagulates and selection of power is carried out in continuous mode radiation spot 300 μm above vernaison vascular arcades when xposition 500 MS with a constant increase power to 100 mW until coagulate 1 degree (light gray). After receiving the test coagulate the received energy left unmodified, and the exposure increase 100-fold to 5000 MS.

The coagulates from 8 to 10 have so that coagulates diameter of 1.8 μm is applied in the projection of soft friends around the foveolar area. When they impose them on each other so that each successive coagulate overlaps the previous 1/8. Then last coagulate put in the center in the area of the fovea. Thereby creating a solid circular spot in the area of the drain druses in age-related macular degeneration. Once exposed to the entire area of the macular zone, the energy created by coagulants, distributed evenly over the entire area of the macular area, creating a great spot.

Together with ozone therapy. To do this, give intravenous drip of saline solution on the background of ozonation gas mixture for 10-15 minutes with ozone concentration at the outlet of the ozonizer 2500 mcgHP To the bottle of capacity of 200 ml with sterile solution connect the disposable system for intravenous infusion. The duct is t connected to the ozonizer through the vial miss ozone-oxygen mixture for 10 minutes, then, on the background of ozonation, the solution is injected intravenously over 15-30 minutes. In addition appoint antioxidant therapy within 3 months by local instillation of emoxipin 1% 1 cap 3 times a day per os komplivit ophthalmic 1 tablet 1 time per day.

After treatment in the near term, six months, and distant the next twelve months, are repeated for each patient, the above methods. Studies show that there is a stabilization process during the year, improving the visual acuity of a long and persistent.

Clinical examples.

Example No. 1.

Sick, Fattakhova GV born in 1946 Diagnosis: OU - Age-related macular degeneration. OD - Pisciforma form (subretinal neovascular membrane, stage of scarring). OS - predictiona form, stage drain druses. At the time of treatment visual acuity was OD-0,1 ext n/a, OS-0,4 nK.

Patient passed a comprehensive examination, including fluorescein angiography. On the left eye marked inhomogeneous slow hyperfluorescence druses drain of nature, likeda and accumulation of the dye was not detected. Optical coherence tomography of the retina beneath the pigment epithelium identified a large number of drain druses.

The power picked up individually depending on the article the penalties pigmentation of the fundus based on the test results. Test coagulates and selection of power held in the CW mode spot 300 μm above vernaison vascular arcades at exposure of 500 MS with a constant increase power to 100 mW until coagulate 1 degree (light gray). After receiving the test coagulate the resulting energy is left unchanged, and the exposure has increased 100-fold to 5000 MS.

Held laser treatment on my left eye - subprogamme impulse impact a wide spot in the projection of the drain druses using the following parameters: the energy of 1050 mW, exposure time 5000 MS, patch 1.8 nm pulses 14.

This made subprogamme impulse impact using infrared diode laser 810 nm IRIDEX IQ 810 (USA) with adapter for wide spots. The coagulates from 8 to 10 positioned so that coagulates diameter of 1.8 μm caused in the projection of soft friends around the foveolar area. When they put on each other so that each successive coagulate blocked previous 1/8. Then last coagulate was put in the Central region of the fovea. Thereby created a large stain in the area of the drain druses. Great spot allows laser therapy for acute exposure to the entire area of the macular zone. The energy created by coagulants, evenly distributed.

Ozone therapy prevodilac the intravenous drip of saline solution on the background of ozonation gas mixture for 10-15 minutes with ozone concentration at the outlet of the ozonizer 2500 mcgHP The bottle of capacity of 200 ml with sterile solution was given a disposable system for intravenous infusion. The duct from the ozonizer connected through the bottle missed ozone-oxygen mixture for 10 minutes, after which the background ozonation solution was injected intravenously over 15-30 minutes. The treatment course is 10 sessions.

At the same time appoint antioxidant therapy within 3 months by local instillation of emoxipin 1% 1 cap 3 times a day per os komplivit ophthalmic 1 tablet 1 time per day.

After treatment in a month, when seen marked improvement of visual acuity on the left eye to 0.5 nK.

The examination after six months, and in the distant, twelve months periods, carried out by such methods as:

- visual acuity with a maximum correction;

- ophthalmoscopy lens Reichel Mainstr 1x Retina;

- photographing of the fundus on the fundus camera Karl-Zeis;

- optical coherence tomography;

fluorescence angiography.

They all showed that visual acuity on the left eye was 0.6 to +0.5 diopters=0,7. A year later the visual acuity on the left eye is stable. Ophthalmoscopically confirmed the decrease in the number of druses, areas of hyperpigmentation. Optical coherence tomography showed a reduction in the Druze under the pigment epic the Liem. Fluorescent, angiographie left eye noted a minor hyperfluorescence due to accumulation of dye remaining friends. The patient was satisfied with the treatment.

Example No. 2.

Sick, Ivanov, M.K. born in 1933 Diagnosis: Age-related macular degeneration predictiona form, stage drain druses both eyes. At the time of treatment visual acuity was OD of 0.4 n/a, OS-0.4 to/K. Held fluorescein angiography of both eyes, on the number of angiograms has been slow hyperfluorescence druses drain of nature, likeda and accumulation of the dye was not detected; optical coherence tomography of the retina beneath the pigment epithelium has identified a large number of drain druses.

The power picked up individually depending on the degree of pigmentation of the fundus based on the test results. Test coagulates and selection of power held in the CW mode spot 300 μm above vernaison vascular arcades at exposure of 500 MS with a constant increase power to 100 mW until coagulate 1 degree (weakly gray). After receiving the test coagulate the resulting energy is left unchanged, and the exposure has increased 100-fold to 5000 MS.

Held laser treatment on my left eye - subprogamme impulse impact a wide spot in the projection of the drain druses (energy 500 mV, exposure to 5000 MS, patch 1.8 nm pulses 14).

This made subprogamme impulse impact using infrared diode laser 810 nm IRIDEX IQ 810 (USA) with adapter for wide spots. The coagulates from 8 to 10 positioned so that coagulates diameter of 1.8 μm caused in the projection of soft friends around the foveolar area. When they put on each other so that each successive coagulate blocked. previous to 1/8. Then last coagulate was put in the Central region of the fovea. Thereby created a large stain in the area of the drain druses. Great spot allows laser therapy for acute exposure to the entire area of the macular area and evenly distributed energy created by the coagulants.

Concurrently held with ozone therapy. This was injected intravenously with saline on the background of ozonation gas mixture for 10-15 minutes with ozone concentration at the outlet of the ozonizer 2500 mcgHP To the bottle of capacity of 200 ml with sterile solution connected disposable system for intravenous infusion. The duct from the ozonizer connected through the vial is skipped ozone-oxygen mixture for 10 minutes, after which the background ozonation solution is injected intravenously over 15-30 minutes. The treatment course is 10 sessions.

At the same time n who appoints antioxidant therapy within 3 months by local instillation of emoxipin 1% 1 cap 3 times a day per os komplivit ophthalmic 1 tablet 1 time per day.

When viewed through the month noted improvement of visual acuity on the left eye to 0.5 n/a 6 months visual acuity on the left eye was 0.6 n/a, right eye without positive dynamics.

For studies of patients six months after treatment, and long - twelve months, used the following methods:

- visual acuity with a maximum correction;

- ophthalmoscopy lens Reichel Mainstr 1xRetina;

- photographing of the fundus on the fundus camera Karl-Zeis;

- optical coherence tomography;

- fluorescein angiography showed.

Held optical coherence tomography and other studies have identified a decrease in the number of druses. A year later the visual acuity on the left eye stable 0.6 n/K. Ophthalmoscopically identified full in the macular area preservation unit druses. Optical coherence tomography has determined under the pigment epithelium, the presence of single friends. After fluorescein angiography of the left eye noted a minor hyperfluorescence on the background of a single soft drusens.

Clinical observations revealed the advantage of the proposed method compared to the same integrated approaches to the treatment of predischarge form of age-related macular degeneration.

The proposed method allows Uchenie predicciones forms of age-related macular degeneration at the stage drain druses by affecting the macular area infrared laser, receiving ozone therapy and local antioxidative therapy.

The proposed method can improve the effectiveness of treatment, to reduce the risk of complications, preduprediti disease progression and increase visual acuity.

Clinical studies have shown that 12 months after coagulation with the use of the proposed method Druze significantly decreased or disappeared altogether.

The proposed method is used in the State budget institution "Kurgan regional hospital for war veterans", and the departments of clinical disciplines and ophthalmology faculty of improvement of professional skill and retraining of specialists of the GOU VPO Tyumen state medical Academy of Roszdrav.

The method of complex treatment of age-related macular degeneration, including the effects of infrared diode laser 810 nm, the creation of a solid circular spots by location coagulants, individual selection power, characterized in that perform a single impact on the macular area subproposal impulse exposure to an infrared diode, coagulates with a diameter of 1.8 μm in an amount of from 8 to 10 have projected soft drusens around the foveolar area, in addition, impose them on each other so that each successive coagulate the switch which indicates the previous 1/8, then last coagulate put in the center in the area of the fovea, together with ozone therapy, this involves intravenous drip of saline solution on the background of ozonation gas mixture, the concentration of ozone at the outlet of the ozonizer is 2500 µg/l, the number of sessions to ten, in addition, together with antioxidant therapy within 3 months by local instillation of emoxipin 1% 1 drop 3 times a day per os komplivit ophthalmic 1 tablet 1 time per day.



 

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3 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to anaesthesiology, resuscitation and urology, and can be applied for prevention of cardiovascular complications in patients with syndrome of endogenous intoxication against the background of acute purulent pyelonephritis in perioperative period. For this purpose reamberine 1.5% in dose 400 ml is introduced to patient from the moment of clinical diagnosis daily to the moment of performing operation. After that, in the process of operation, at the stage of kidney decapsulation infusion of reamberine in the same dose in combination with intravenous blood irradiation is realised, with duration constituting 25 minutes. After that, in post operational period reamberine infusion is continued in the same dose during 8 days. Simultaneously for 3 days after operation intravenous blood irradiation is realised. From the 4-th day of post-operative period for five days reamberine infusions 1 time per day are combined with transdermal laser irradiation of operated kidney projection with duration 10 minutes. Then, without stopping reamberine infusion, biologically active points, connected with heart meridian C1, C2, C3, C4, C5, C6, C7, C8, C9, sympathetic point of heart meridian V15, ear points AP19, AP21, AP60, AP100, AP105, AP115 are successively exposed to laser irradiation.

EFFECT: method ensures effective prevention of cardiovascular complications due to reduction of level of toxic action of products of peroxide oxidation of lipids on myocardium, which makes it possible to improve functional state of myocardium.

1 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurooncology, and may be used for the intraoperative diagnosis of cerebral and spinal tumour borders and determination of the tumour resection quality. What is presented is an intraoperative combined spectroscopic diagnostic technique for cerebral and spinal tumours which involve the preoperative preparation including the oral administration of hydrochloride-5-aminolevulinic acid (several hours before the tumour resection). Actually the intraoperative spectroscopic analysis of the tumour marker content in the analysed tissues (5-aminolevelinic acid-induced protoporphyrin IX), as well as its desintegration products, oxygenated and reduced hemoglobin; the tissue scattering properties are varied using broadband and laser geode light source and a fibre-optic probe. The broadband light source is used within the range of 500÷600 nm, while the exiting fluorescent laser/diode light source - at wave length 620÷640 nm. The diffuse-reflectance spectra of the broadband and laser/diode light, as well as fluorescence are recorded at the same time. After the spectroscopic characteristics have been automatically classified, the operative radicality is assessed.

EFFECT: presented method enables higher reliability of the intraoperative measurements in neuronavigation, reducing time needed for implementing them, providing deeper probing and simplifying the spectra recording in vivo.

4 cl, 9 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to cosmetic and pharmaceutical industry and represents a method for improving the transdermal permeability of therapeutic or cosmetic topical preparations involving the dermal administration of 1.0 to 300.0 vol. % of liquid xenon as a part of an acceptable neutral carrier or a therapeutic or cosmetic preparation.

EFFECT: invention provides the higher therapeutic or cosmetic effectiveness ensured by improving the transdermal transport of bioactive compounds.

8 cl, 13 ex, 4 dwg

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