RU2242955C1 - Method for preventing apoptosis of ganglious cells in patients with primary glaucoma at normal intraocular pressure - Google Patents

Abstract

FIELD: medicine, ophthalmology.

SUBSTANCE: patients are prescribed the combination of glycine and phesame per 1 tablet thrice daily and per 2 tablets twice daily, correspondingly. Therapy should be continued for 1 mo. The innovation enables to stabilize visual functions and increase patient's acuity.

EFFECT: higher efficiency of prophylaxis.

1 ex, 1 tbl

Description

The invention relates to medicine, namely to ophthalmology.

There is a method of treating glaucomatous optical neuropathy in patients with normal ophthalmotonus with the neurotropic drug “Semax” (Kurysheva NI, Shpak AA, Ioleva E.E. et al. “Semax” in the treatment of glaucomatous optical neuropathy in patients with normalized ophthalmotonus . Bulletin of Ophthalmology., 2001, No. 4, p. 5-8). Referring to experimental data, the authors note that “Semax” has a pronounced protective effect on the development of hemorrhagic shock, acts as an immunomodulator, is able to activate the production of anti-inflammatory cytokines (p. 6), and also participates “in the regulation of nerve growth factor and neurotropic factor growth ”(p. 7).

The disadvantage of this method is the need for combination with drugs that improve blood circulation, metabolism and trophic; when using it, no effect on the microcirculation of the eye, anti-ischemic action, increased biosynthesis of RNA and ATP were noted.

Closest to the claimed is a method of treating patients with primary open-angle glaucoma with the nootropic drug “Pantogam” (Davydova N.G., Borisova S.A., Kolomeytseva E.M. et al. Effect of pantogam on the visual function and hemodynamics of the eyes of patients with glaucoma. Ophthalmology Bulletin) , 2002, No. 5, p.3-5).

The authors note that “Pantogam” is a nootropic drug, it easily penetrates the blood-brain barrier, and accumulates mainly in the nervous tissue. It affects the central mechanisms of GABAergic vasomotor regulation, improving energy metabolism and blood supply to the brain. The drug was prescribed 0.25 g 3 times a day. The course of treatment is from 1 to 4 months, in some cases up to 6 months.

The disadvantage of this method is that, as the authors themselves note, improvement in hemodynamics after a course of pantogam treatment prevailed in patients with initial (1) stage of glaucoma and the effect of pantogam on visual acuity was not revealed (page 4). In addition, when using, there is no increase in the biosynthesis of RNA and ATP, no anti-ischemic effect is expressed.

The technical result of the invention is the stabilization and preservation of visual functions in patients with primary open-angle glaucoma.

The technical result is achieved by the fact that patients are prescribed glycine in tablets of 0.1 g × 3 times a day under the tongue and phosam in capsules 1 × 2 times a day inside for 1 month.

Example. Case history No. 124 for 2003 of the ophthalmic department of the City Clinical Hospital No. 17 of the city of Voronezh, patient, aged 70 years. Diagnosis: open-angle far-reaching glaucoma compensated by both eyes. He was registered in the clinic for 5 years with a diagnosis of glaucoma. Conducted courses of conservative therapy 2-3 times a year. Ocupres 0.25% dripped 2 times in both eyes. Intraocular pressure (IOP) did not increase above 24 mmHg. Visual function was constantly declining.

Upon receipt of the right eye: visual acuity of 0.3 is not corr. Field of view 300 degrees (the sum of the eight meridians). IOP = 24 mmHg The environments are transparent. Optic nerve disc with glaucomatous escation. Left eye: visual acuity 0.1 not corr. Field of view 290 degrees. IOP = 22 mmHg The environments are transparent. Optic nerve disc with glaucomatous escation.

In the hospital, studies were conducted to identify compensation for IOP: daily tonometry, tonography, perimetry, a study of the central field of view within 30 degrees, gonioscopy. Compensation of IOP was established and the patient was discharged for outpatient treatment: glycine 1 t. × 3 p. under the tongue before eating, Fezam 1 t. × 2 p. after eating for 1 month, 0.25% ocupres - 2 p. - in both eyes. After completing the course of treatment, the visual acuity of the right eye increased to 0.5, the field of view expanded to 400 degrees. Left eye: visual acuity increased to 0.2, the field of view expanded to 405 degrees. IOP has remained unchanged.

In more detail, comparative data of treatment by the proposed method and known similar methods for patients with distant glaucoma are presented in the table. The most informative indicators were compared: visual acuity, field of view (VF) - the sum of 8 meridians and the number of visual field defects (VDV).

In this way, 35 patients with a distant stage of primary open-angle glaucoma with normal intraocular pressure were treated. Efficiency assessment was carried out according to the state of visual acuity, field of view, blind spot area, tonometric and tonographic indicators. The study was carried out after 1, 3 and 6 months.

The decrease in the area of central and paracentral cattle, the expansion of the peripheral boundaries of the field of vision, increased visual acuity, increased secretion of intraocular fluid.

The advantage of the proposed method is a more pronounced and persistent effect of increasing visual acuity, visual field, reducing the number of drugs taken orally and low cost.

Claims (1)

A method for the prevention of ganglion cell apoptosis in patients with primary glaucoma with compensated intraocular pressure by prescribing a combination of preparations of neurotransmitter, vasodilating and neuroprotective effects, characterized in that patients are prescribed 0.1 g × 3 times a day in tablets of glycine and 1 capsule × 2 in phosam once a day for a month.