COMPARISON OF DIFFERENT METHODS OF PHYSIOTHERAPY TREATMENT IN THE MANAGEMENT OF PRIMARY OPEN-ANGLE GLAUCOMA

Abstract

Background: Therapeutic action of physical therapy aims at the recovery of conductibility of optic tracts, improvement of microcirculation and hemodynamics, stimulation of regulatory brain structures and improvement of psycho-neurological status of patients. Aim: To assess efficacy of transcranial magnetic therapy, contemporary transcranial magnetic therapy/electrostimulation and magnetic sympathocorrection in the treatment of primary open-angle glaucoma. Materials and methods: 397 patients (634 eyes), aged 58–76 years, with verified diagnosis of stage I, II or III primary open-angle glaucoma, received transcranial magnetic therapy (group 1, 182 eyes), contemporary transcranial magnetic herapy/electrostimulation (group 2, 258 eyes) and magnetic sympathocorrection (group 3, 194 eyes). All patients underwent routine ophthalmological examination, visual evoked potential recording and assessment of ocular circulation. Results: In patients with initial stage of glaucoma, most prominent changes of electrophysiological parameters was demonstrated in the group 2: visual evoked potential amplitude increased from 8.4 ± 0.4 to 11.3 ± 0.2 mcV, latency decreased from 77.6 ± 1.3 to 70.4 ± 2.1 ms. Maximal improvement of ocular circulation (decrease of resistance index of posterior short ciliary arteries from 0.69 ± 0.02 to 0.51 ± 0.03) was registered in the group 3. In patients with evolved glaucoma (stage II), significant increase of P100 amplitude of visual evoked potentials (from 7.5 ± 0.2 to 9.8 ± 0.3 mcV) was found in the group 2; latency period decreased from 84.6 ± 1.5 to 74.8 ± 2.1 ms. In stage II glaucoma patients, prominent increase of systolic blood velocity was demonstrated in groups 3 and 2: from 11.26 ± 0.8 to 13.64 ± 0.63 cm/s and from 10.5 ± 0.2 to 13.9 ± 0.7 cm/s, respectively. Resistance index decreased from 0.76 ± 0.05 to 0.52 ± 0.02 and from 0.75 ± 0.02 to 0.65 ± 0.02 in groups 3 and 2, respectively. In advanced glaucoma (stage III), most prominent increase of P100 amplitude of visual evoked potentials was demonstrated in group 2: amplitude of visual evoked potentials increased from 6.5 ± 0.2 to 8.1 ± 0.2 mcV, latency decreased from 87.5 ± 2.3 to 80.1 ± 2.1 ms. Maximal improvement of ocular circulation (increase of systolic blood velocity from 9.2 ± 0.72 to 11.2 ± 0.6 cm/s) and decrease of resistance index (from 0.84 ± 0.04 to 0.66 ± 0.03) was found in patients with stage III glaucoma in the group 3. Conclusion: Use of different methods of magnetic therapy especially in combination with electrostimulation activates ocular hemodynamics and stimulates bioelectric activity of visual cortex and may prevent visual functions impairment in glaucoma.

Keywords

• magnetic therapy
• electrostimulation
• sympathocorrection
• primary open-angle glaucoma