Role of immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

Abstract

Background. An increase in the incidence of optic neuritis (ON) among the workingage population, the complexity of etiological diagnosis and the choice of adequate etiotropic therapy, as well as a disappointing prognosis for vision due to the development of optic nerve atrophy determines the high social significance of this problem.The aim. Comprehensive clinical, functional, morphometric and laboratory-immunological evaluation of results of using the drug Imunofan® in combined treatment of ON associated with herpesvirus infection (HVI).Materials and methods. The study involved 39 people (39 eyes) with acute ON associated with HVI. The standard treatment regimen for the patients included the appointment of solutions: dexamethasone in a decreasing scheme, a 1 % Emoxypine® preparation 0.5 ml and 12.5 % Dicynone® preparation 0.5 ml through an irrigation system implanted into the retrobulbar space, with subsequent appointment of medicinal means of neuroprotection (Picamilon® and Semax®). All patients were divided into two groups. The main group – 22 patients, whose standard inpatient treatment was supplemented with intramuscular administration of the drug Imunofan®, 50 μg daily for 10 days. The control group consisted of 17 patients, who were treated only according to the standard method.Results. Analysis of obtained data showed that more significant positive dynamics was noted in patients of the main group.Conclusion. The clinical efficacy of the drug Imunofan® in the complex therapy of ON associated with HVI was characterized by relief of signs of inflammation in the optic nerve in the main group immediately after the end of the course of treatment, while in the control group – only after 3 months; an increase in the best corrected visual acuity by 1.3 times, a decrease in the incidence of postneuritic optic nerve atrophy at a follow-up period of 12 months.

Keywords

• optic neuritis
• herpesvirus infection
• corticosteroid therapy
• immunotherapy