RU2077877C1 - Method for treating vascular pathologies of eyes - Google Patents

Abstract

FIELD: ophthalmology; treatment of pathologic vascular conditions in eyes. SUBSTANCE: 0.5 ml of 1%-emoxypin solution is introduced into retrobulbar space 4 times daily, every 4 h, for 10-20 days, through fixed catheter. EFFECT: higher effective cure for blood vessels of eyes.

Description

 The invention relates to medicine, namely to ophthalmology and can be used in the treatment of vascular eye pathology.

 Closest to the proposed method is the Romashchenko method (ed. St. USSR N 1410973, class A 61 F 9/00, 1988), which consists in the fact that a streptodecase solution is introduced into the retrobulbar space through a catheter followed by emoxipine electrophoresis, after the catheter procedure delete.

 The disadvantage of this method is trauma.

 The purpose of the invention is to reduce trauma and improve visual function.

 This goal is achieved by the fact that a 1% solution of emoxipin is injected into the retrobulbar space 4 times a day through a polyvinyl catheter fixed retrobulbar.

 A comparative analysis of the proposed solution with the prototype shows that the proposed method differs from the known one in that in order to improve and reduce the morbidity, a 1% solution of emoxipin is administered 4 times a day through a polyvinyl chloride catheter fixed retrobulbarly in the retrobulbar space.

 The method is as follows.

 An ordinary metal needle with a mandrel up to 40 mm long with an inner diameter of 0.3 mm and a mandrel up to 0.3 mm in diameter to a depth of 3.5-4.0 cm toward the top of the orbit is inserted into the lower-outer corner of the eye socket. The end of the mandrin is left in retrobulbar space. A soft polyvinyl chloride catheter with an inner diameter of 0.35 mm and an outer diameter of 0.6 mm is inserted along the mandrin. Mandren is removed. The skin around the catheter is treated with a solution of brilliant green, the catheter is fixed with adhesive tape and closed with a rubber plug. Subsequent injections of the drug are performed through the plug with an injection needle 4 times a day after 4 hours.

 Comparative data with patients with the same pathology, but treated without emoxipin, showed the following.

 Under observation were 6 patients with thrombosis of the central retinal vein and its branches, vascular optic neuropathy (3 patients with hemophthalmus and 3 patients with hemorrhagic retinopathy).

 The control group consisted of patients with a similar pathology: 7 patients with thrombosis of CVC and its branches, 3 with vascular optic nephropathy, 4 with hemophthalmia and 4 patients with hemorrhagic retinopathy. Duration of treatment ranged from 10 to 20 days. The effect of treatment depended on the duration and severity of the disease.

 Visual acuity on average, compared with the control group, was 0.15-0.2 higher in all cases, except for patients with optic neuropathy, where only in 1 case the effect was not achieved, in the other it increased from 0 , 05 to 0.3.

 By the time of discharge, in 2 patients with hemorrhagic retinopathy and in 1 patient with thrombosis, the branches of CVC hemorrhage completely resolved.

 In the control group of patients in all cases of hemorrhage partially resolved.

 Defects in the field of view decreased and disappeared much faster, but persisted in only one case in a patient with optic vascular neuropathy. In the control group, absolute and relative scotomas were preserved in 7 patients.

Example 1. Patient M., 72 years old, was admitted with a diagnosis of thrombosis of the superior temporal central vein of the retina of the right eye. Two weeks ago, vision decreased sharply. On admission, visual acuity: 0.1 does not correct the right eye; left eye 0.8 + 1.0 ^D 1.0.

 On the fundus of the right eye, multiple hemorrhages along the upper temporal branch of the central retinal vein and in the macular region.

 Catheterization of retrobulbar space of the right eye was performed by the proposed method. A metal needle with a length of up to 40 mm with an inner diameter of up to 0.3 mm with a mandrel up to 0.3 mm in diameter to a depth of 3.5-4.0 cm towards the apex of the orbit was inserted into the lower outer corner of the eye socket. The needle on the mandrel was withdrawn, leaving its end in retrobulbar space. A soft polyvinyl chloride catheter with an inner diameter of 0.35 mm and an outer 0.6 mm was introduced along the mandrin. Mandren removed. The skin around the catheter was treated with a solution of brilliant green. The catheter was fixed with adhesive tape and closed with a rubber plug. Subsequent injections of the emoxipin solution were made through a plug with an injection needle 4 times a day after 4 hours for 10 days.

At discharge, the visual acuity of the right eye is 0.4 + 1.0 ^d = 0.6 (the left eye is the same). At the fundus hemorrhages are pale, in the stage of resorption. Three months after discharge, the patient was examined, visual acuity: right eye 0.6 + 1.0 ^d = 0.6.

 Example 2. Patient B., 47 years old, was admitted with a diagnosis of central serous chorioretinopathy of the right eye.

On admission, vision of the right eye: 0.5 + 0.5 ^d = 0.7. Objectively: the eye is calm, edema in the macular region on the fundus, relative scotoma in the field of view. Catheterization of retrobulbar space by the proposed method. Over the next 14 days, a 1% solution of 0.5 ml of emoxipin was injected into the catheter 4 times a day. At discharge: right eye vision 0.9. Objectively: the right eye is calm, there is no edema in the macular region, the periphery is not changed, the scotoma is not detected in the field of view.

Example 3. Patient Z. 60 years. Diagnosis: macular degeneration of both eyes. On admission: vision of the right eye 0.3 + 1.0 ^d 0.4, vision of the left eye 0.2 + 1.0 ^d 0.3. Central relative scotoma, yellowish foci in the macular region.

 Within 15 days, both eyes were treated according to the proposed method.

At discharge: vision of the right eye 0.5 + 1.0 ^d 0.7, vision of the left eye 0.4 + 1.0 ^d 0.7. The central scotoma is absent, small yellowish foci are preserved in the macular region.

 Example 4. Patient S. 50 years old, with a diagnosis of diabetic retinopathy. On admission: vision of the right eye of 0.3 n / a (not corrected), vision of the left eye of 0.7 n / a. Objectively: scotomas, there are many hemorrhages of various shapes and sizes on the fundus (relative and absolute scotomas in the field of view).

Both eyes were treated according to the proposed method for 18 days. At discharge, the vision of the right eye is 0.7 n / a, the left eye is 0.8 + 0.8 ^d 0.9. Hemorrhages in the fundus completely resolved. In the field of view, single relative scotomas.

 Thus, the application of the proposed method allows you to stably restore visual function in a short time, less traumatic way, since the catheter is fixed in retrobulbar space and there is no need for its repeated (or multiple) installation. It is possible to create a constant concentration of epoxipin in the lesion. The method is simple, convenient to use, does not require special training and expensive equipment.

Claims (1)

 A method for the treatment of vascular pathology of the eyes, including topical administration of emoxipin, characterized in that emoxipin is introduced into the retrobulbar space through a fixed catheter in an amount of 0.5 ml of a 1% solution 4 times a day after 4 hours for 4 hours for 10 20 days.