Офтальмохирургия (Jan 2016)
Modern possibilities increasing efficiency of medical rehabilitation in patients with acute ischemic optic neuropathy
Abstract
Purpose. To study an efficiency in the system of pathogenetic treatment of patients with anterior ischemic optic neuropathy (AION).Material and methods. The research included 43 patients with an acute AION phase. The average age of patients was 52.3±4.5 years. All patients were divided into two groups. The study group consisted of 23 patients. The system of treatment included retrobulbar implantation of a silicone catheter to the posterior pole of the eye with infusion of medicinal preparations (MP): Cerepro (dose 0.5 ml), then with interval of 1 hour, 0.5 ml of 5% Mexidol solution for injections and then 5 mg of Cortexin. After a two-hour break, retrobulbar MP infusions were repeated. The control group consisted of 20 patients who underwent the traditional method of injections of Cerepro, Mexidol and Cortexin. At the same time the patients of both groups of study within 10 days received daily a course of magnetic stimulation using the AMO-ATOS device with the OGOLOVE attachment («Trima», Russia).Results. After the end of treatment in a hospital, in the main group of patients there were noted: increase of visual acuity, expansion of visual field limits, electrophysiological indices authentically exceeded the similar data obtained in patients of the control group. According to degrees of functional disorders severity after one year of the treatment the degree I prevailed in the main group of patients, less often the degree II of optic nerve atrophy (ONA) (9 individuals, 40%). According to degrees of functional disorders severity one year after the treatment in the main group of patients the degree I prevailed, and less often the degree II of optic nerve atrophy (ONA) (9 individuals, 40%). Among the patients of the control group the ONA degrees II-III were met more often.Conclusions. The therapeutic effect of system of treatment, including sub-Tenon’s retrobulbar infusion of MP for neuroprotection, of patients with AION was manifested in: increase of visual acuity by 1.5 times, expansions of the total of the visual field limits on the average by 69.5±4.9 degrees, decrease of number of absolute and relative scotomas by 1.6 times, increase of amplitude by 1.35 times and decrease of latency of visual evoked potential by 1.2 times, in comparison with traditional methods of implantation of MP. More significant favorable functional results in AION patients of the main group were achieved thanks to an increase of blood flow indices in short posterior ciliary arteries.
