RU2131233C1 - Method for treating glaucoma - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves applying medical preparations instillations and bandage impregnated with mixture of the following composition, mas. %: 2%-novocaine solution, 30; 1%-nicotinic acid solution, 30; 4%-Tauphon solution, 30; and dimexid, 10. The bandage is applied to skin for 40-60 min twice a week during the 1-2 months long time interval. The treatment course is to be repeated 3-4 times during 1 year. EFFECT: stable normalization of intraocular pressure and vision function.

Description

 The invention relates to medicine, in particular otthalmology, and for the conservative treatment of patients with glaucoma.

 An important reason for the increase in intraocular pressure (IOP) in glaucoma is ischemia of the eyeball, especially its anterior section, leading to degeneration of the drainage zone of the anterior chamber angle (CCP) and a decrease in the outflow of intraocular fluid (HPV) (S.N. Fedorov et al., - In: Issues of the pathogenesis and treatment of glaucoma, M., 1981, pp. 26-32).

 A known method of treating glaucoma surgically (N.T. Timoshkina, Experimental and clinical study of the antiglaucomatous operation of scleranguloreconstruction - Abstract - Diss. Cand. Medical Sciences - M., 1978, 16 pp.).

 The mechanism of action of surgical interventions is due to an increase in the outflow of intraocular fluid through the excised part of the drainage zone of the anterior chamber angle.

 The disadvantage of this method is that this eliminates the effect, and not the reason for the increase in intraocular pressure. In addition, operations are not always effective. After them, in some patients, a decrease in visual functions continues and intraocular pressure is not always compensated.

 There is a method of conservative treatment of glaucoma by normalizing intraocular pressure, for this, local medication therapy for myotic instillation is used (E. I. Kovalevsky, - In.: Ophthalmology, M., "Medicine", 1995, S. 280-282).

 The disadvantage of this method is that the mobility of the pupil stops, there is a narrowing of the vessels, especially the anterior sections of the eye, exacerbating its ischemia.

The objective of the invention is to develop a conservative method for the treatment of glaucoma:
a) with functional blockage of the drainage wall of the anterior chamber angle and periodically increased, unstable, increased or normal outflow of intraocular fluid, normal on myotics or slightly increased intraocular pressure (in the stage of preglaucoma and initial glaucoma);
b) operated glaucoma, including repeatedly.

 The technical result is a stable normalization of IOP and stabilization of visual functions.

The technical result is achieved by the fact that in the method of treating glaucoma, including conventional drug therapy - instillation of drugs, according to the invention, an additional bandage is applied to the skin of the forehead, soaked in a mixture of the following composition, wt.%:
2% Novocaine solution - 30
1% Nicotinic acid solution - 30
4% Taufon solution - 30
Dimexide - 10
and it is left for 40-60 minutes, while the procedure is carried out 2 times a week for 1-2 months with a repeat of the course 3-4 times a year.

 With this method, intraocular and orbital hemodynamics are corrected, and extraocular tissues are affected. As a result of pharmacological stimulation of the frontal and orbicular muscles, local vasodilation of the capillary bed of the orbit occurs simultaneously with an increase in the blood flow of the intraocular vasculature, which leads to a persistent decrease in IOP and stabilization of visual functions.

 The proposed method treated 20 patients. Of these, with a positive result 18.

 Example 1

 Patient K., 69 years old.

 The diagnosis is the right eye (OD) - open-angle 1st stage of glaucoma, the left eye (OS) - open-angle 1-stage glaucoma.

For the first time, an increase in intraocular pressure (IOP) in both eyes (OI) and a decrease in visual acuity in both eyes was noticed about 8 years ago. Therapeutic treatment was ineffective. IOP data prior to pharmacological stimulation by applying dressings soaked in the mixture according to the invention:
Right eye (OD) = Po = 18.9; C = 0.29; F = 2.6; Po / c = 65
Left eye (OS) = Po = 24.4; C = 0.35; G = 5.0; Po / c = 70
Visual acuity (visus) OD = sph + 1.5 ^d = 0.9-1.0 n / a OS = sph + 2.0 ^d = 0.8-0.9 n / a
Fundus: OD - optic nerve disc (optic nerve disc) pale with clear boundaries, glaucomatous excavation = 0.4 - 0.5.

 OS - DZI pale with clear boundaries, glaucomatous excavation = 0.4 - 0.5.

The patient was given a dressing course impregnated with the mixture according to the invention, the dressing was applied for 60 minutes to the forehead skin 2 times a week for 1 month in combination with Sol instillations. Ophimoli 0.25% 2 times daily in both eyes. The course was repeated 3 times a year for 3.5 years. After the course of treatment, IOP amounted to: OD = Po = 15.9; C = 0.32; F = 1.9; Po / c = 90
OS = Po = 17.3; C = 0.22; F = 1.6; Po / c = 79
visus OD = sph + 1.0 ^d = 1.0
OS = sph + 1.5 ^d = 0.9 - 1.0 n / k
Output:
After a course of treatment according to the invention, we compensated for intraocular pressure and increased visual function with a decrease in spectacle correction.

 Example 2

 Patient P., 71 years old.

 Diagnosis: right eye (OD) - open-angle II stage operated unstabilized glaucoma, left eye (OS) - open-angle III-stage operated unstabilized glaucoma.

 For the first time, an increase in IOP in both eyes and a decrease in visual acuity in both eyes was noticed about 4 years ago. Vision decreased gradually. Therapeutic, surgical and laser treatments have proven ineffective.

cyl + 0,5 ax 165^o = 0,7 - 0,8 н/к
O = 0,2

cyl + 1,5 ax 0^o = 0,3 н/к
Глазное дно: ОД - ДЗН серый, с четкими границами, глаукоматозная экскавация = 0,7 - 0,8. OS - ДЭН серый, с четкими границами.IOP data prior to pharmacological stimulation by applying dressings soaked in the mixture according to the invention:
OD = Po = 22.4; C = 0.08; F = 1.0; Po / c = 280
OS = Po = 26.6; C = 0.09; F = 1.5; Po / c = 295
OD = 0.3 sph + 1.03 ^d

cyl + 0.5 ax 165 ^o = 0.7 - 0.8 n / k
O = 0.2

cyl + 1.5 ax 0 ^o = 0.3 n / k
The fundus of the eye: OD - DZN gray, with clear boundaries, glaucomatous excavation = 0.7 - 0.8. OS - DEN gray, with clear boundaries.

 Glacomatous excavation = 0.92 1.0.

 The patient was given a dressing course impregnated with the mixture according to the invention, a dressing was applied for 60 minutes to the forehead skin 2 times a week for 1.5 months (12 sessions) in combination with Sol instillations. Arutimoli 0.25% 2 times daily in both eyes.

cyl + 0,5 ax 165^o = 0,8 - 0,9 н/к
OS = 0,2

cyl + 1,0 ax 0^o = 0,4 н/к
Вывод:
После проведенного нами курса лечения согласно изобретению компенсировалось внутриглазное давление и повысились зрительные функции при уменьшении очковой коррекции.After the course of treatment, IOP amounted to
OD = Po = 15.9; C = 0.32; F = 1.9; Po / c = 90
OS = Po = 18.9; C = 0.29; F = 2.6; Po / c = 65
visus OD = 0.3 sph + 0.75 ^d

cyl + 0.5 ax 165 ^o = 0.8 - 0.9 n / k
OS = 0.2

cyl + 1,0 ax 0 ^o = 0.4 n / k
Output:
After our course of treatment according to the invention, intraocular pressure was compensated and visual functions increased with a decrease in spectacle correction.

 Example 3

 Patient D., 88 years old.

 The diagnosis is the right eye (OD) - open-angle III-c stage operated unstabilized glaucoma, the left eye (OS) - open-angle III-stage operated unstabilized glaucoma.

 For the first time, an increase in IOP in both eyes and a decrease in visual acuity in both eyes was noticed about 10 years ago. Vision decreased gradually. Therapeutic, surgical, and laser treatments have proven ineffective.

IOP data prior to pharmacological stimulation by applying dressings soaked in the mixture according to the invention:
OD = Po = 29.0; C = 0.24; F = 4.6; Po / c = 121
OS = Po = 24.4; C = 0.27; F = 3.9; Po / c = 90
OD = 0.01 n / k
OS = 0.08 n / a
The fundus of the eye: OD - DZN gray, with clear boundaries, glaucomatous excavation = 0.9 - 1.0. OS - DZN gray, with clear boundaries, glaucomatous excavation = 0.9 - 1.0.

The patient was given a dressing course impregnated with the mixture according to the invention, the dressing was applied for 60 minutes to the forehead skin 2 times a week for 2 months in combination with Sol instillations. Jumoldi 0.25% 2 times a day in both eyes. The course was repeated 3 times a year for 3 years. After the course of treatment, IOP amounted to
OD = Po = 18.9; C = 0.29; F = 2.6; Po / c = 65
OS = Po = 17.3; C = 0.22; F = 1.6; Po / c = 79
OD = 0.02 - 0.04 n / a
OS = 0.09 - 0.1 n / k
Output:
After our course of treatment according to the invention, intraocular pressure was compensated and visual functions increased.

Claims (1)

A method for the treatment of glaucoma, including the installation of antihypertensive drugs, characterized in that in addition to the forehead skin, a bandage is impregnated with a mixture of the following composition, wt.%:
2% Novocaine Solution - 30
1% Nicotinic Acid Solution - 30
4% Taufon Solution - 30
Dimexide - 10
and left for 40-60 minutes, while the procedure is carried out 2 times a week for 1 to 2 months with a repeat of the course 3-4 times a year.