RU2213545C1 - Method for treating the cases of endocrine ophthalmopathy - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering steroid therapy. The treatment being over, 10% sterile placenta albumin solution is administered at a retrobulbar dose of 1.5-3.0 ml 1-2 times a week. The total treatment course is 15-20 injections long. EFFECT: long term regression of the pathologic process.

Description

 The invention relates to medicine, in particular to ophthalmology, and can be used in the complex treatment of endocrine lesions of the orbit.

 Currently, there are several methods for treating endocrine ophthalmopathy: surgical, medication with the inclusion of corticosteroids, enzyme therapy, immunocorrective treatment, radiation therapy.

 Of these methods, the most effective is the method of steroid therapy, taken as a prototype. The known method is aimed mainly at suppressing elements of inflammation in endocrine ophthalmopathy. Moreover, treatment options for corticosteroids are individual. When prescribing corticosteroids orally, the daily dose of prednisolone is 40-80 mg with a gradual withdrawal according to the scheme, the course of treatment is 1100-1200 mg. Perhaps a combination of retrobulbar injections of dexazone (at least 10 times) with oral administration of the drug. One option for intensive therapy with steroidal patients is pulsotherapy. Within 3 days, 1000 mg of methylprednisolone is administered dropwise intravenously. In the future, the patient is transferred to oral administration of corticosteroids at a dose of 40-50 mg, followed by a gradual dose reduction: 3 times 500 mg, 4 times 250 mg, 4 times 125 mg (Brovkina A.F. Complex treatment of endocrine ophthalmopathies depending on forms and stages. Methodical manual for doctors // M. - 1996. - 14 p.).

 Despite the great effectiveness of glucocorticoid drugs, their use is often accompanied by side effects (a manifestation of drug Cushingoid syndrome, withdrawal syndrome, decreased natural resistance to infections, impaired carbohydrate metabolism).

 However, often, despite a long course of steroid therapy, it is rarely possible to achieve complete stabilization of the process with the elimination of all clinical symptoms (periorbital tissue edema, ptosis, and restoration of the range of motion of extraocular muscles). When they are canceled, an aggravation of the process develops, which requires prolonging the course of treatment.

 We set the task to develop a method of conservative treatment of endocrine ophthalmopathy in order to obtain a long-term regression of the pathological process and prevent the development of relapses.

 To solve this problem, a method for the treatment of endocrine ophthalmopathy is proposed, which consists in steroid therapy of the pathological process, characterized in that at the end of steroid therapy, treatment is continued with a 10% sterile solution of placental albumin, which is administered in a dose of 1.5-3.0 ml retrobulbar 1-2 once a week, while the course of treatment is 15-20 injections.

 The wide spectrum of action of the drug albumin (Registration number 68.837.2 VFS 42-1105-81) is due to the presence of various biologically active substances in its composition, including steroid hormones associated with the main albumin protein, which creates a background of mild steroid effects on the pathological process and local immunosuppression. Thus, the formation of steroid dependence and steroid-resistant forms of the disease proceeding with residual edema of periorbital tissues and activation of autoimmune reactions is reduced.

 The proposed method of treatment is as follows. Steroid therapy for patients with endocrine ophthalmopathy is carried out with a 0.4% dexazone solution, at a dose of 1.0 ml in the form of retrobulbar injections once a day every other day with a general course of 10-15 injections. After the end of the course of steroid therapy, patients are prescribed placental albumin. Use in the form of a 10% sterile solution. Introduce 1.5-3.0 ml retrobulbar 1-2 times a week. The course of treatment is 15-20 injections.

 The combined phased use of corticosteroids and albumin has a prolonged therapeutic effect and leads to a more pronounced and lasting therapeutic effect.

 Example. Patient P. Case history 5142. D / S: OD - endocrine ophthalmopathy. The morphological diagnosis is verified. After a course of steroid therapy, the patient is prescribed a placental albumin preparation of 1.5 ml retrobulbar 2 times a week. The course of treatment was 10 injections.

 A persistent therapeutic effect was achieved: the absence of pain in the orbit, a decrease in the degree of exophthalmos, improved reposition and mobility of the eye, good visual functions.

 The treatment in 9 patients made it possible to ascertain the absence of relapse, the stabilization of the process in the follow-up period of more than 1.5 years.

 Thus, as a result of a phased combined effect: treatment with corticosteroids and albumin, a long-term regression of the pathological process is achieved.

Claims (1)

 A method of treating endocrine ophthalmopathy, consisting of steroid therapy of a pathological process, characterized in that at the end of steroid therapy, treatment is continued with a 10% sterile solution of placental albumin, which is administered at a dose of 1.5-3.0 ml retrobulbar 1-2 times a week while the course of treatment is 15-20 injections.