RU2559151C2 - Method of treating demodectic blepharoconjunctivitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to ophthalmology, and is intended for treatment of demodectic blepharoconjunctivitis. Method includes processing eyelash edges of patient's eyelids and eyebrows successively with 10% or 5% benzylbenzoate oiltment, uniderm cream, emolium emulsion. Course of treatment includes two 4-day cycles with two-week break. Procedures are carried out two times per day with 6-hour time interval. Intervals between application of medications constitute respectively 15 and 10 minutes.

EFFECT: high penetrating ability of benzylbenzoate in combination with applied medications makes it possible to considerably reduce treatment terms and reduce possibility of recurrences.

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Description

The invention relates to medicine, namely to ophthalmology, and is intended to reduce the time and increase the effectiveness of the treatment of demodectic blepharoconjunctivitis.

Demodectic blepharoconjunctivitis (DBK) - eyelid damage caused by a conditionally pathogenic parasite - a tick of the genus Demodex subspecies P.folleiculorum, which lives in the eyelash follicles (Akbulatova L.Kh. // Bulletin of Dermatology and Venereology. - 1966, No. 12 - P.57- 61).

In the treatment of DBK, the most widely used acaricides in the form of gels, ointments, alcohol solutions - zinc ichthyol ointment, agents containing sulfur (demolan, glycodem, blepharogel - 2), alcohol solutions of bitter wormwood and calendula (Zatsepina N.D., Maychuk Yu.F., Semenova G.Ya. Eye damage in demodicosis: Method. Recommendations. - M. 1983 - 17 p.).

The main disadvantage of these funds is their low efficiency and long term of treatment (up to 45 days), which ultimately leads to the development of dry eye syndrome, significantly reduces the quality of vision and requires constant supportive installations.

Reducing the duration of treatment is possible with the integrated use of the above acaricidal agents.

There is a method of treating blepharoconjunctivitis by combining zinc-ichthyol ointment with alcohol tincture of wormwood (RU 2254838 C1, 06/27/2005).

The method includes treating the intermarginal eyelid edge with alcohol tincture of wormwood and bitter zinc and ichthyol ointment for 10 days, subsequent processing of the eyelid edges with zinc ichthyol ointment with propolis tincture for 14 days.

The full therapeutic effect was achieved between 24 and 30 days of treatment. The elimination of mite individuals was revealed on the 7-14th day, the duration of the clinical manifestations of DBK was 10-16 days, relapses occurred after 3-6, 12 months.

The disadvantages of the above method:

- treatment effectiveness only in cases of uncomplicated DBK;

- the likelihood of a relapse within 3-6 months from the end of treatment;

- the possibility of allergic reactions from the use of alcohol tincture of propolis;

- if long-term treatment is necessary, alcohol tinctures create a risk of dry eye syndrome.

A known method of treating DBK using ointment "Demolan-asset", in which the main active ingredient is a highly concentrated wormwood extract obtained using supercritical carbon dioxide (RU 2313356 C1, 10.27.2007).

Ointment "Demolan-asset" allows you to reduce the treatment time to 21 days with a moderate degree of invasiveness.

This is achieved by using carbon dioxide as a solvent, which increases the concentration of the active principle of wormwood extract by 10 times.

However, with a higher invasion of mite individuals, the treatment period is 30-45 days.

Thus, the above methods of treating DBK shorten the duration of treatment only for uncomplicated forms of the disease.

The use of metronidozole ointments in the treatment of demodecotic blepharitis and blepharoconjunctivitis ointments also reduces the treatment period to only 28-30 days (RU 2192860 C1, 11/20/2002; RU 2126668 C1, 02/27/1999).

There is a method of acaricidal treatment of demodicosis blepharoconjunctivitis, including the use of a physiotherapeutic method that combines the application of a drug composition of lamifaren gel and sodium thiosulfate to the edges of the eyelids, followed by irradiation of the intramarginal edge of the eyelids with low-frequency infrared laser radiation from the Rubin attachment to the device "RUO-Atos AT550550 5" C1, 12/10/2010).

The treatment effect is achieved due to the influence of laser radiation, as a result of which photo-dissociation of thiosulfite occurs with the formation of sulfur and sulfur dioxide, causing the death of mite individuals, larvae and eggs. Destruction of mite individuals occurs within 15 days.

However, the method is applicable only in the presence of an infrared laser with a wavelength of 650 nm, the ability to purchase which not all clinics have.

The effect of treatment persists for only 5-6 months, after which treatment must be repeated.

In addition, the use of laser glasses, which are superimposed on the eyes with a mixture on them, creates problems with their sterilization, because the device is also used to treat other eye diseases.

It is known that under the influence of laser radiation, the properties of not only the main active substances, but also other components that make up the medicinal composition (water, micro and macro elements, vitamins, algins, fuanatsen) change. The effects of these components with altered properties on the cells and tissues of the eyelids are unknown.

The main reason for limiting the effectiveness of the above methods is the low penetrating ability of the main active ingredients used (bitter wormwood extract, calendula, metronidozole, zinc-ichthyl ointment, sulfur-containing compounds). These substances penetrate the mite through the respiratory system. The death of individuals of the tick occurs mainly due to paralysis of the respiratory muscles, the internal organs are exposed to a weaker effect.

The objective of the invention is to develop a method for the treatment of blepharitis and blepharoconjunctivitis caused by Demodex ticks, which can significantly reduce the duration of treatment and reduce the likelihood of relapse.

The problem to be solved and the expected technical result is achieved by the claimed method for the treatment of demodecotic blepharoconjunctivitis, including the use of benzyl benzoate ointment in combination with uniderm cream and emulsion emulsion.

Benzyl benzoate is used in dermatology for the treatment of head lice, scabies, demodicosis. With a high penetrating ability, it enters the tick through the chitinous cover, accumulates in toxic concentration, and affects the vital organs and reproductive organs. The death of ticks occurs in 7-32 minutes (http://www.piluli.ru/product/Benzilbenzoat). There is no information on the use of benzyl benzoate in ophthalmology.

Uniderm cream has anti-inflammatory, antipruritic, antiexudative properties. In combination with ointment, benzyl benzoate is used to a greater extent as a decongestant.

Emulsion emolium regenerates the skin, relieves dryness and itching, creates an active lipid layer on the surface of the edges of the eyelids, which protects the skin from water loss and from the effects of adverse factors, eliminates the occurrence of dry eye syndrome.

The treatment course of the claimed method includes two cycles of 4 days with a break of two weeks. The cycle procedures are performed twice a day with an interval of 6 hours according to the following sequence of operations:

1. 10% benzyl benzoate ointment is applied to the ciliary edges of the eyelids and eyebrows of the patient by means of a stick with a cotton ball.

2. Uniderm cream is applied after 15 minutes.

3. After that, after 10 minutes, an emulsion emulsion is applied to the ciliary edges of the eyelids and eyebrows.

4. In the morning of each next day during the toilet, the patient flushes the remains of the preparations from the eyebrow and ciliary edge of the eyelids.

5. On the fifth day, at the end of the cycle, microscopy is performed to determine the results.

6. After 14 days, the cycle repeats.

Example 1

Patient R. 36 years. DS - Demodectic blepharitis in both eyes. Before treatment with microscopy, 12 mite individuals, 10 nymphs, 4 eggs were found.

The first cycle of treatment was carried out for 4 days with 10% benzyl benzoate ointment, followed by the application of Underm cream and emolium emulsion. On the 2nd day, edema of the eyelids and conjunctival hyperemia decreased. On the 3rd day, the itching and foreign body sensation disappeared.

In the morning on the 5th day, microscopy was performed, 3 adult mites, 2 nymphs were found.

After 14 days, a second cycle of treatment was carried out according to the developed scheme.

After the end of the cycle, the mite was not detected during microscopic analysis. When viewed after 6 months, the tick was not found.

Example 2

Patient B., 68 years old. DS - demodectic blepharoconjunctivitis (relapse after treatment with alcohol solution of calendula, demolan cream and zinc drops (vitabact). Microscopy revealed 6 adults, 2 eggs, 8 nymphs. After the first treatment cycle, 10% benzyl benzoate ointment, uniderm cream and emolan emulsion with microscopy revealed 1 nymph Clinical manifestations were not observed.

After the second cycle, the tick was not found. At the control examination after 6 months, the tick was not found.

Example 3

Patient A., 56 years old. DS - Demodecosis blepharoconjunctivitis. When handling, 4 adult mites, 1 egg, 3 nymphs were identified.

After the first and second treatment cycles, the tick was not found. Clinical manifestations were not observed. After a follow-up examination after 6 months, the tick was not found.

Example 4

Patient C.25 years. DS - Demodecosis blepharoconjunctivitis. When handling laboratory revealed 2 adults, 2 nymphs.

Due to hypersensitivity to benzyl benzoate ointment, treatment was carried out at a concentration of the main substance of 5%.

After the first and second cycle of treatment, the tick was not found.

The claimed method of treatment has the following advantages:

- has the highest efficiency since the value of the acarogram decreases several times on the 4th day or becomes negative, an absolutely negative result is achieved after 8 days of treatment with the estimated norm of effectiveness: a decrease in the value of 2 or more times on the 7th day and a negative value on the 14th day (RU 2249211 C1 March 27, 2005);

- the absolute treatment effect (complete destruction of the tick, larvae and eggs) is achieved in 4 to 8 days;

- clinical manifestations of demodectic blepharitis, blepharoconjunctivitis stops for 3-4 days;

- the destruction of the tick occurs in 4-8 days, which is much less than its life cycle (15 days) and is a factor sharply reducing the likelihood of relapse;

- a significant reduction in treatment time and its scheme create more comfortable conditions for patients, virtually eliminates the complications that occur with other methods of treatment.

In total, 110 patients (220 eyes) were treated by the claimed method. At the control examination after 12 months, 96 of them 87.2% of the tick was not found. The remaining 14 patients revealed 0 - 1 individuals.

Thus, the claimed method of treatment of demodectic blepharoconjunctivitis significantly reduces the duration of treatment and significantly reduces the likelihood of relapse.

Claims (1)

A method of treating demodecotic blepharoconjunctivitis, characterized in that it includes treating the ciliary edges of the eyelids and eyebrows of the patient with 10% or 5% ointment of benzyl benzoate, uniderm cream, emulsion emulsion, the treatment course includes two cycles of 4 days each with an interval of two weeks, the procedures are carried out twice a day with a time interval of 6 hours, the intervals between application of the drugs are respectively 15 and 10 minutes.