Method of treating retinal and vitreous hemorrhage

FIELD: medicine.

SUBSTANCE: treating retinal and/or vitreous hemorrhages is ensured by a session of subcutaneous administration of Histochrom 0.5 ml into a mastoid bone, Echinacea compositum 1.0 ml into a temporal fossa, Gemase 2500-5000 IU parabulbary dissolved in Lymphomyosot 0.5-1.0 ml. The therapeutic course is 10-15 sessions, either daily or every second day.

EFFECT: faster resolution of the intraocular hemorrhages, prevention of retinal injuries by toxic decay products, higher visual acuity.

3 ex

 

The invention relates to medicine, namely to ophthalmology, and is intended for the treatment of hemorrhages in the retina and the vitreous body.

One of the causes of low vision, blindness, and disability among older persons, but in the younger age groups are vascular diseases of the eye. One of the manifestations of vascular disorders are bleeding in the retina and in the vitreous body, causing a decrease in visual acuity, retinal detachment, secondary glaucoma, retinal degeneration, etc.

Currently, in the treatment of vascular diseases of the eye are widely used vasodilator drugs, vitamins, bio-stimulants, antioxidants, angioprotectors. However, despite the wide selection of medicines, the task of creating a new, effective, affordable with no side effects of medicines remains relevant.

There is a method of treatment of hemorrhages in the vitreous body (hemophthalmus by daily intravenous infusion of a solution gemodeza in combination with complex medicines: parabulbar injection of dexamethasone, etamzilat sodium, magnetophoresis with collision, injections tohoto under the skin of the temple (EN 2231338).

The known method of conservative treatment of the case of using hypertonic solutions: chlorine is Yes sodium, glucose, mannitol, an osmotic pressure which is higher than in blood plasma (Gundorov R.A. and other eye Injuries, - M.: Medicine, 1986, s-286).

However, low-molecular hypertonic solutions increase the osmotic component of the pressure of blood plasma and is removed in the bloodstream liquid fraction streamed into the vitreous body of blood, effective only during the infusion, as quickly removed from the vascular system due to induced osmotic diuresis.

There is a method of treatment of the case, including the conduct of daily intravenous infusions of balanced on the main electrolytes in the blood plasma solution gemodeza (EN 2148972, 20.05.2000).

There is a method of treatment of hemorrhage of the retina with the help of homeopathic remedies - Phosphorus, Arnica, Lachesis (T.A. Granikova. Short course on homeotherapy. L., 1991, s). However, the method is not effective enough, as it has a therapeutic effect on all stages of the disease.

The closest analogue of the proposed method is a method of the same purposes, including the use of complex homeopathic remedies containing Phosphorus, Arnica, Lachesis, Apis, Nux vomica and Carbo vegetabilis (EN 2242237, 20.12.2004).

The task of the invention is to develop a new homeopathic method of treatment of hemorrhages in the retina and the vitreous body.

Technical re is the query result of the proposed method is accelerated resorption of intraocular hemorrhages, warning damage to the retina toxic products of decomposition with increasing visual acuity.

Technical result is achieved due to the combined effect with the use of drugs: injected subcutaneously in the region of the mastoid process of the drug Histogram, in the region of the temporal fossa - drug "Echinacea compositum"entered parabulbarno drug "Gamesa"diluted the drug "under given circumstances".

The basis of a combined treatment of said pathology is thrombolytic therapy, which aims at dissolving the resulting hemorrhage and restoration of the local blood flow. One of the most effective fibrinolitikov for local use in ophthalmology believe the drug "Hamasu". Having fibrinolytic and disaggregated action, "Gamesa" promotes lizirovania venous thrombus, rapid recovery of blood flow in the affected Vienna and resorption of hemorrhages in the eye fundus. The drug is used in the form of parabulbar injection of 5,000 IU 1 time a day for 10 days (Neroev CENTURIES, Lysenko V.S. Treatment of hemorrhagic syndrome in vascular diseases of the retina. // Manual for doctors. M., 2004. P.1-10).

Drugs under given circumstances" and "Echinacea compositum" are homotoxicological means, produced by the German firm "Heel" are included in the register of medicines, approved for use in the Russian Federation.

According to the literature, between the cytoplasmic membrane of the microvilli of the epithelial cells of the retina and the membrane of the photoreceptor is detected by the slit-like space formed interphotoreceptor matrix secreted by cells of the pigment epithelium and consists of chondroitin sulphate (60%), sialic (25%) and hyaluronic (15%) acids (Sh. Acharya, I.R. Rodriguez, E.F. Moreira et al. SPACR, a Novel Interphotoreceptor Matrix Glycoprotein in Human Retina That Interacts with Hyaluronan. // J. Biological Chemistry, 1998. N.273 (47). P.31599-31606). Violation of the structural organization of the matrix is the reason for the development of various types of retinal degeneration. Zhukov, S., Shchuko A.G., Malyshev V.V. Pigment abiotrophy of the retina. M: GEOTAR-Media, 2010, 112 S.

Under given circumstances - the drug, the point of application of which is the extracellular matrix. Under given circumstances is increased its drainage function. Its use allows not only to lyse hemorrhage, but also to contribute to the elimination of the products of lysis of the retina. In the matrix, the drug activates the end products of glycation, which contributes to the activation of eliminating degradation products of the extracellular matrix.

The drug "under given circumstances" is the product of water-based, because the drug "Gamesa", according to the instructions, diluted in water use under given circumstances as a solvent is not contradictory, the cheat instructions. Thus, when recommended for introduction into parabulbar space the volume of liquid you can enter two drugs that act on different pathogenic components of the pathological process in hemorrhages in the retina and the vitreous body.

The drug Echinacea compositum has a multi-component composition and has Antihemorrhagics, immunostimulatory, anti-inflammatory, analgesic action General therapy 2010-2011. The catalog of preparations of firm "heel". ZAO Arabia, 2012.

The drug Histogram" refers to the antioxidant drugs, it stabilizes the cell membrane, is the interceptor free of reactive oxygen species, free radicals, has chemoresistance, retinoprotective effects (Egorov E.A., Alekhine, VA, Volobueva T.M., Fedoseev S.A., Mishchenko, NP, Koltsova E. New mountianside "Histogram" in the clinic of eye diseases. To oftalmol. 1999; 2:34-35).

The complex of the drugs used simultaneously to provide action on the resolution and prevention of further bleeding, and excretion of toxic degradation products, as well as to the stimulation of local immunity.

Clinically this is manifested in resorption, hemorrhage, reducing edema syndrome and, consequently, to improve the sharpness of SREN what I what is the ultimate goal of therapy.

The method is as follows. The surface of the skin in the injection process 70% alcohol. For the introduction of drugs selected the following areas of regional blood flow: insulin syringe subcutaneously in the region of the mastoid process impose drug Histogram in a volume of 0.5 ml, in the region of the temporal fossa drug Echinacea compositum" in a volume of 1.0 ml, parabulbarno drug "Gamesa" 2500-5000 ME running to the drug "under given circumstances", in the amount of 0.5-1.0 ml, the rate of 10-15 sessions every day or two.

Patient X. 36 years old, was admitted to the Hematology unit 20.08.12 with a diagnosis of Acute leukemia. T-lymphoblastic option.

Upon examination by an ophthalmologist: complaints about sudden decreased vision in the left eye during the 16 days, the presence of a Central scotoma. Visual acuity of the right eye and 1.0; the left - 0,1 not also corrected. The position of the eyeballs correct movement in full, convergence in norm. Anterior segment without features. The fundus of the right eye: optic nerve disc pale pink, clear boundaries, the retinal vessels - twisted sharply, artery uneven caliber, with faint blood flow, the veins are tortuous, irregular caliber, full, extended, macular region and the periphery without focal changes.

The fundus of the left eye: optic nerve disc pale pink, borders Schusev the us, excavation saved on the upper pole Azkaban hemorrhage with indistinct contours, tortuous retinal vessels, neravnomernomu caliber with faint blood flow, the veins are tortuous, irregular caliber, full, extended, along the vascular arcades retinal hemorrhages with indistinct contours, variegated, swelling of the macular area, hemorrhage in the macula with clear contours in the area of the foveolar pit.

Was diagnosed with OS - acute circulatory disturbance of the retina, incomplete thrombosis of the CCS; OU - angiopathy of the retina.

After consultation with the attending physician was treated under the proposed method, including local injection of drugs Gamesa ME 5000 dissolved on the under given circumstances 1,0 parabulbarno; Echinacea compositum of 1.0 in the temporal region and Histogram 0.5 in the region of the mastoid process to the left. Eye care was only complementary to the treatment of the underlying disease and was conducted during therapy Protocol Hoeltzer 99.

RESULTS. On the 10th day from the start of treatment ophthalmoscopically noted a significant decrease in edema of the macula. Visual acuity of 0.1. By this time it was done 4 sessions combined injection. After 2 weeks from the start of treatment after 6 sessions of injections, the patient noted a subjective depression of the Central scotomas. Visual acuity of 0.1. A-day treatment after 9 sessions marked improvement of visual acuity to 0.4. Altogether there were 15 sessions of injection treatment. Ophthalmological status after treatment of the following: visual Acuity of the right eye and 1.0; the left eye was 0.9 (not also corrected). In dynamics, the patient noted significant improvement of visual functions. The fundus of the left eye: optic nerve disc pale pink, clear boundaries, hemorrhage along the vascular arcades and disk area resorbed. In the field of foveolar pit hearth red color with clear contours. There macular reflex, ophthalmoscopically visible swelling there. The tortuous retinal vessels, uneven caliber arteries narrowed veins full-blooded, the ratio A:B=1:2.

The improvement from the side view correlated with the improvement of the General condition of the patient. When viewed through 3-month visual acuity of the right eye and 1.0; the left eye is 1.0. Anterior segment of both eyes without pathology. Optical transparent environment. The fundus of the eye is almost the same in both eyes. The optic nerve disc pale pink, clear contours, the retinal vessels narrow, hypotonie, tortuous, vascular figure depleted. Retin-a pink, shiny, macular reflex pronounced edema no. In comparison with the right eye, the macula in the left eye has a more intense color. When viewed through 6 months visual acuity of the right eye and 1.0; the left eye is 1.0. Anterior segment without pathology. The fundus of the eye di is to: pale pink with clear boundaries; the retinal vessels tortuous, constricted, A:V=1:2; macular area: reflex saved, foveola bright red color with clear contours.

Produced study fundescola pictures is determined by the redistribution of pigment yellow spots on the EAST - scanning - the accumulation of pigment in the field of foveolar pit compared to the right eye. Thus, a comprehensive treatment of the method described above allowed us to achieve resorption of hemorrhages, resolution of macular edema and recovery of visual acuity of the affected eye.

Patience So, 42 years old, came with complaints of blurred vision in the left eye, the feeling of fog over the left eye in the last 10 days. Noted paroxysmal headache about 2 weeks ago, which was bound by the emotional stress. Visual acuity of the right eye and 1.0 in the left eye - 1,0 IOP OD 20 mm Maklakova, OS 19 mm Maklakova. Anterior segment of both eyes without features. The fundus of the right eye: optic nerve disc pale pink, clear contours, tortuous retinal vessels, arteries narrowed stopovers tortuous veins full-blooded, normal caliber, tense, A:B=1:2, the macula without features, reflex saved. The fundus of the left eye: optic nerve disc pale pink, clear contours, tortuous retinal vessels, arteries narrowed stopovers tortuous, Vienna polnoc is Aries, normal caliber, tense, along vernaison vein swelling of the retina, soft vatoobraznye exudate white, variegated hemorrhage,/temporal Vienna uneven caliber with faint blood flow in/temporal artery narrowed sharply in places spacerowa, in the macula without pathological changes, somewhat reduced macular reflex. The field of vision of the right eye is in the normal range, the left eye was recorded loss verkhnevizeiskogo sector, not affecting the Central area up to 20 degrees. The patient was treated in a specified way: Gamesa ME 5000 dissolved on the under given circumstances 1,0 p/b; Echinacea compositum of 1.0 in the temporal region and Histogram 0.5 in the region of the mastoid process, was injected drugs with 2 sides, because of the phenomenon angiopathy were expressed with 2 sides. The sessions were held through the day, No. 10 of treatment. Upon completion of the course: the visual Acuity of the right eye and 1.0 in the left eye to 1.0. Anterior segment of both eyes without features. The fundus of the right eye: optic nerve disc pale pink, clear contours, tortuous retinal vessels, arteries are narrow, tortuous veins moderately full, normal caliber, A:B=1:2, the macula without features, reflex saved. The fundus of the left eye: optic nerve disc pale pink, clear contours, tortuous retinal vessels, arteries narrowed saved corkscrew tortuous in the field top the temporal arcades, infiltrates, hemorrhage resorbed, swelling regressed, Vienna full, normal caliber, A:B=1:2-3.

Field of view is fully recovered to the limits of physiological norm.

Thus, a comprehensive treatment of the method described above has resulted in resorption of hemorrhages and exudates, recovery of visual fields and visual functions of the affected eye.

Patience M, 59 years old was admitted to the neurology Department with a diagnosis of Diabetic encephalopathy. Moderate vestibular-atactic Sandra, angina 2 FC. Arterial hypertension 2 tbsp., risk 4. Diffuse-nodular euthyroid goiter 1 tbsp. Sugar diabetes type 2, insulin dependent, severe, subcompensated. The state after baloney angioplasty with stenting anterior descending, circumflex, diagonal, right coronary artery from 2006

During the examination the ophthalmologist noted sudden loss of vision in his right eye within the last 10 days.

Visus

OD: O/SP (b/C): account of the fingers of a person sph: n/a

OS: On/SP (b/C): 0,5 sph: - 1,0 O/WR (from/to): 0,7.

Anterior segment of both eyes without features. When biomicroscopy: OD total hemophthalmus. The fundus of the eye - the Central area is not ophthalmoscopically, on the periphery of the multiple different-sized hemorrhages. OS: in the vitreous body floating pomot is possible. The fundus of the eye disc: pale pink with clear boundaries in the area of the optic nerve disc growth of newly formed blood vessels, proliferation in the vitreous body; vessels: the tortuous, artery moderately constricted veins full of uneven caliber, different-sized hemorrhages, deposition of hard exudates throughout the retina. Diagnosis: Diabetic proliferative angiopathy OS. Total hemophthalmus OD. The patient was treated under the proposed method daily right: Gamesa ME 5000 dissolved on the under given circumstances 1,0 p/b; Echinacea compositum of 1.0 in the temporal region and Histogram 0.5 in the region of the mastoid process. After 2 days, the patient had depression fog in front of the right eye. Visual acuity accounted for 0.08. 6 days after the 4 sessions of combined treatment visual acuity OD=0,2. The fundus was not ophthalmoscopically. 11 days after 8 sessions of combined treatment the visual acuity of the right eye was 0.5 n/a, the left eye of 0.5 sph(-)1,0=0,7. Treatment was done 8 sessions on the proposed method. The treatment was not continued due to discharge of the patient from hospital. This case demonstrates the rapid resolution total hemophthalmos with improvement of visual acuity in the complex therapy on the proposed method. The patient was assigned to outpatient treatment.

Thus, the proposed pic is b allows to achieve the cupping process and improve visual acuity in patients with severe eye pathology.

A method of treatment of hemorrhages in the retina and vitreous body, wherein subcutaneously in the region of the mastoid process impose drug Histogram in a volume of 0.5 ml, in the region of the temporal fossa drug Echinacea compositum in a volume of 1.0 ml, parabulbarno - drug "Gamesa" 2500-5000 ME running to the drug "under given circumstances", in the amount of 0.5-1.0 ml, the rate of 10-15 sessions every day or two.



 

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SUBSTANCE: invention is related to medicine, namely to angiologia and may be used for local lysis of obstructing thrombus inside any vessel. Catheter is used with balloon, which is blown to complete obturation of vessel, and fibrinolytic agent is introduced under pressure into produced space, isolated from one side with catheter balloon and thrombus on the other side, until complete lysis of thrombus.

EFFECT: method makes it possible to increase efficiency of treatment due to creation of high concentration of fibrinolytic agent in the area of thrombus and action of pressure at thrombus, and also to achieve reduction in number of complications.

1 dwg, 1 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmology and can be used in surgery of subretinal haemorrhages combined with age-specific macular dystrophy with subretinal neovascular membrane. The technique involves subtotal vitrectomy and removal of posterior hyaloid membrane. Bevacizumab and Ranibizumab are injected intravitreally. It is followed with intravitreal injection of tissue plasminogen activator and expanding gas while a patient is pronated.

EFFECT: method allows deploying blood from under retina, ensuring pathogenetic action on haemorrhage source, preventing proliferative processes in vitreal cavity.

2 ex

FIELD: medicine.

SUBSTANCE: polypeptides include single-domain antibody against vWF, A1 domain of vWF, A1 domain of activated vWF, A3 domain of vWF, gp1b and/or collagen. Invention claims methods of obtaining indicated polypeptides, methods of coating devices applied in medical practice (e.g. in X-ray structural analysis, endoprosthetics) with indicated polypeptides.

EFFECT: obtainment of polypeptides for treatment of diseases requiring modulation of thrombocyte-mediated aggregation.

40 cl, 69 ex, 30 dwg, 32 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically to cardiology and concerns treating the patients suffering chronic cardiac failure. The method involves administering pharmacologically active relaxin H2 in a therapeutically effective amount equal to 10-480 mcg/kg a day. An indication for adding relaxin to the conducted therapy is chronic and stable compensated congestive cardiac failure at the moment of the beginning of treatment.

EFFECT: method provides reducing a rate of decompensation, a rate or length of stay in hospital, a risk of as compared to no-relaxin treatment.

6 cl, 2 ex, 3 tbl, 13 dwg

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