RU2120264C1 - Method for treating transsudative forms of central chorioretinal dystrophy - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves injecting 1% thiotriazoline solution at a dose of 0.5 ml once a day in parabulbar administration mode during 10- 14 days. EFFECT: enhanced effectiveness of treatment; accelerated treatment course. 2 cl, 1 tbl

Description

 The invention relates to medicine, namely to ophthalmology and can be used in the treatment of transudative forms of central sclerotic chorioretinal dystrophy, myopic transudal dystrophy, central serous choriopathy.

 Recently, transudative forms of central chorioretinal dystrophies are among the main causes of a significant and persistent decrease in visual acuity.

 Known means and methods of treating this pathology are not effective enough.

 In addition, due to the lack of developed production of these funds in Ukraine, their acquisition is expensive.

 There is a method of treating the above diseases, which consists in the parabulbar administration of retiline, but its use without additional use of other drugs is not very effective, although it provides an increase in visual acuity by an average of 20%, but there is no improvement in the condition of the fundus (Savko V.V. and et al. The effectiveness of retilin in the treatment of involutional central chorioretinal dystrophy. Ophthalmol., Journal, 1992, N 5-6, S. 293-295).

 There is also a method of treating such a pathology with a laser (Ivanishko Yu.A., Bochkareva A.A. Efficiency of laser and conservative treatment of "dry" and disciform senile macular degeneration. Results of a separate observation. - Ophthalmol., Journal, 1992, N 5-6 , p. 286-289).

 The disadvantage of this method is that laser coagulation is dangerous in the treatment of pathological foci of fovelar localization and it itself can cause the growth of newly formed vessels, as well as the transition of "dry" forms of senile macular degeneration into transudative ones.

 Laser coagulation does not reduce the risk of central vision loss during senile macular degeneration, does not prevent recurrence of the transudative process, although it reduces the frequency of relapses.

 A known method of reducing intraocular pressure by introducing into the eye a quinoxaline derivative, which is used as a compound of hydrogen, methyl, bromine, chlorine (Russian patent N 1829937, CL A 61 K 31/494).

 The disadvantage of this method is that it, reducing intraocular pressure, does not contribute to increased visual acuity, does not stop the development of various forms of dystrophy and the recurrence of their relapses.

 A known method for the treatment of subatrophy of the eyeball, including the introduction into the eye cavity of a solution of polyvinylpyrrolidone with a mol.m of 350,000 Da (Russian patent N 1827224, A 61 F 09/00). This method provides a persistent increase in ophthalmotonus, is not ineffective in the treatment of transudative forms of central chorioretinal dystrophy (TFSHHD).

There is a method of treating retinal dystrophy by using antioxidants, in which the physiological oxidative system parameters are determined: red blood cell peroxide resistance, molon dialdehyde content, glutathione peroxidase activity in red blood cells and blood plasma of patients and, depending on the results, direct antioxidants are prescribed:
- tocophenol acetate and ascorutin, indirect antioxidants: methylmethionine, chloride, lichenic acid, glutamic acid or in the complex direct and indirect antioxidants / Russian patent NN 1833730, class. 5 A 61 F 09/00.

 The disadvantage of this method is the difficulty of accurately determining all physiological parameters of the oxidative system, the duration of treatment, the large number of drugs used and the lack of unification of treatment of all forms of TFSHKhD.

 The closest in technical essence and the achieved effect is the treatment method, which consists in the complex use of several drugs: improving microcirculation (trental), normalizing metabolic and redox processes / vitamin B6, FIBS, toferol parmidin, anti-sclerotic / cinarizine // V.I. . Morozov, A.A. Yakovlev, Pharmacology of Eye Diseases, Moscow: Medicine, 1989, p. 156 /.

The disadvantages of this method are: the unreasonableness of the appointment of numerous drugs in the geriatric aspect (the indicated pathology affects mainly elderly people), since elderly patients are more likely to experience side effects of the drug, their delayed elimination from the body, the unpredictability of the interaction of several drugs;
pathogenetic mechanisms of sclerotic macular degeneration are not taken into account, in particular, permeability disturbance of the “basal complex of the retina and choroid;
there is no differentiated approach to the treatment of "dry" and transudative forms;
duration of treatment (the course of treatment lasts about a month, and stabilization of visual functions is observed for 5-6 months);
lack of effectiveness.

 The basis of the invention is the task of developing a method for the treatment of TFCC, ensuring the universality of treatment of all forms of this pathology, increasing the effectiveness of treatment, eliminating side effects, reducing treatment time and costs.

 This objective is achieved in a method of treating transudative forms of central chorioretinal dystrophies by introducing a drug into the eye, due to the fact that a 1% solution of thiotriazoline is administered as a drug, which is injected into the eye parabulbarly at 0.3-0.6 ml once a day within 10-14 days.

 The study of patent and medical information confirms the novelty of the above set of features, and therefore, the novelty of the proposed method meets the criteria of the invention.

 The invention is illustrated by the following description: thiotriazolin as a synthetic hepatoprotective, cardioprotective drug with anti-ischemic, membrane-stabilizing, antioxidant and immunomodulatory activity was registered on 05/05/04 by order of the Ministry of Health of Ukraine N 85, registration N 94/85/1 and approved for serial production and clinical practice.

 By the same order registered under N 94/85/3 1% solution of thiotriazoline for injection.

 The solution of thiotriazoline is an indirect type of antioxidant, acting at the initial stages of lipid peroxidation and reactivating the antioxidant complex.

 The method is optimally carried out by parabulbar administration of a 1% solution of thiotriazoline daily at 0.5 ml per eye 1 time per day for 10-14 days.

 Treatment control is carried out using a study of visual acuity, visual field, research on the Amsler grid, ophthalmoscopy, and fluorescence fundus anti-imaging.

 Examples of the method.

 Example 1

Patient N., 33 years old, and.b. N 2617, Diagnosis: central serous choriopathy of the right eye. Upon receipt, the visual acuity of the right eye of 0.5 with a correction of 0.1 D = 0.7, the left eye of 1.0. In the field of view of the right eye is the relative central scotoma, an area of 110 ^o . The dimensions of the dynamic scotoma maladaptation - 28 cm ² . The recovery time of visual acuity / import / after photosestest - 90 s. Electrical sensitivity / EC / and Ospen lability: 60 μA and 58.8 Hz on the right, respectively, 42 μA and 52.3 Hz on the left. With ophthalmoscopy in the central parts of the fundus of the eye, a portion of the edematous retina is determined on the right with a size of two diameters of the optic nerve disc, and there are no macular and fauvelar reflexes.

 The treatment was carried out: 1% solution of thiotriazoline parabulbarno 0.5 ml once a day, decongestants with potassium preparations. The course of treatment was 16 days.

 At discharge, the visual acuity of both eyes is 1.0. Dynamic scotoma maladaptation, as well as visual field defects during perimetry are not determined. Import by photo test - 52 sec. ESP and L data for Fosphen: on the right - 45 μA and 58.9 Hz on the left - 44 μA and 56.6 Hz.

 With ophthalmoscopy, the fundus on the right is without signs of swelling, the macular and fauvelar reflexes are restored. On admission, two “leakage points” and transudate under the retina in the center were revealed on fluorescence angiograms upon admission, but there were no “leakage points” on discharge, and no extravasation appeared.

 Example 2

Patient K., 65 years old, and.b. N 7516. Diagnosis: central sclerotic transudative chorioretinal dystrophy, immature age-related cataract of both eyes. Visual acuity at admission: 0.08 on the right (does not correct), 0.2 on the left with a correction of 2.0 D = 0.3. When perimetric revealed absolute central scotomas measuring 158 ^o on the right and 60 ^o on the left.

 Ophthalmoscopically in the macular region of both eyes, “wet” dystrophic foci are determined (on the right is the Kunt-Unius disk-shaped lesion) pigment redistribution. ESP and L data on Fosphen: the right eye - 120 μA and 32.8 Hz, the left eye - 85 μA and 48.2 Hz. The treatment was carried out: decongestants with potassium preparations, B vitamins, tissue preparations, 1% thiotriazoline solution of 0.5 ml once a day parabulbarno and 2.0 ml intramuscularly daily, piracetam (10% solution of 0.5 ml subconjunctival , 20% solution intramuscularly daily). The course of treatment was 21 days.

When extracting visual acuity: amounted to 0.2 - of the right eye / does not correct / 0.3 - 2.0 D = 0.6 of the left eye. A decrease in the area of central cattle was noted: up to 85 ^o on the right, up to 20 ^o on the left. The electrophysiological indicators (EF and L according to Fosphen) improved, which were: 85 μA and 48.4 Hz on the right, 60 μA and 54.6 Hz on the left. On the fundus at discharge, a decrease in the phenomena of extravasation. On fluorescence angiograms, a decrease in the area of serous retinal detachment and “leakage zones”.

 The proposed method for the treatment of transudative forms of central chorioretinal dystrophy was used in the treatment of 86 patients. The results are shown in the table.

 Using the proposed method allows to improve the functional results of treatment, increase visual acuity, improve electrophysiological parameters, normalize the permeability of structures, the "basal" fundus of the fundus, reduce transudative manifestations in the fundus, reduce treatment time, reduce the number of relapses.

 In addition, thiotriazolin is not toxic, does not cause side effects and is suitable for the treatment of patients of all ages.

Claims (2)

 1. A method of treating transudative forms of central chorioretinal dystrophies by administering a medicament, characterized in that a thiotriazoline solution administered parabulbularly into the eye is used as a medicament.  2. The method according to p. 1, characterized in that they use a 1% solution of thiotriazoline in 0.5 ml 1 time per day for 10-14 days.

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