Object: Optimization of treatment in early stages of combined fundus pathology diabetic retinopathy (DR without DME) and dry type of age-related macular degeneration (AMD AREDS I, II, III).Patients and methods:120 people (150 eyes). Study group 1 (SG1) — control 60 people. (60 eyes); study group 2 (SG2) — 30 people. (30 eyes) — DRI without DME and AMD AREDS I, II, III) treatment: 1 year with angioprotective calcium dobezilate (Doxi- Hem®) dose of 500 mg 3 after 6 months, 500 mg once a day for 6 months and at the same time 1 year antioxidant agent (Retinorm) 1 capsule 3 times a day; study group 3 group (SG3) 30 people. (30 eyes) — with DRO and dry type of AMD (AREDS I, II, III) 1 year Retinorm 1 capsule 3 times a day; study group 4 (SG4) with DRI without DME — 30 people. (30 eyes) 1 year Doxi-Hem®. Monitoring: monthly standard ophthalmologic examination, control of diabetes mellitus (HbA1C) compensation, VEGF-A vascular endothelial growth factor in tear.Results.Visual acuity increased on the background of treatment in all three groups (IG2,3,4): in SG2 from 0.72 ± 0.02 to 0.87 ± 0.02, p < 0.05; the thickness of the retina decreased from 290.2 ± 2.1 to 268.85 ± 2.2 μm, p < 0.05, the photosensitivity increased from 21.0 ± 0.2 to 25.1 ± 0.2 dB p < 0.05; in the tear VEGF-A to 415.4 ± 4.6 pg/ml, p < 0.05. In SG3, visual acuity increased from 0.74 ± 0.02 to 0.88 ± 0.02, p < 0.05; the thickness of the retina decreased from 287.7 ± 2.0 to 272.8 ± 2.2 μm (р < 0.05); increased photosensitivity from 21.3 ± 0.2 to 24.5 ± 0.2 dB, p < 0.05; in the VEGF-A slip to 416.6 ± 5.0 pg/ml, p > 0.05. In IG4 visual acuity increased from 0.70 ± 0.02 to 0.78 ± 0.02, p < 0.05; the thickness of the retina decreased from 288.1 ± 4.4 to 280.1 ± 2.4 μm, р < 0.05; the photosensitivity increased from 21.2 ± 0.2 to 23.2 ± 0.2 dB; VEGF-A up to 415.9 ± 3.8 pg/ml, p > 0.05.Conclusion. Combined therapy of angioprotective (Doxi-Hem®) and antioxidant therapy (Retinorm) with timely appointment at early dry stages of combined pathology (DR and AMD) will allow to stabilize, delay the development of severe forms of the disease.
There was studied the therapeutic efficacy ofinhalations ofaerosolform ofaprotinin delivered by a propellant in the metered-dose inhaler (MDI). This clinical trial was performed during the winter-spring outbreak caused with pandemic Influenza H1N1pdmO9. Aprotinin (a natural antiprotease low molecular weight polypeptide from bovine lungs) is known to be an antiviral drug, which inhibits influenza virus proteolytic activation accomplished by host respiratory proteases. Patients inhaled 2 aerosol doses of aprotinin (160 Kallikrein-inhibiting Units (KIU)) each 2 hours for 5 days. In comparison group, patients were treated with Ingavirin (a synthetic peptidoamine with unknown antiviral target), 90 mg per dayfor 5 days. On day 2 after treatment viral loads in naso-pharyngeal washes were determined. In aprotinin patients about the tenfold decrease of viral load was determined in comparison to Ingavirin patients. Duration of clinical symptoms, such as rhinorrhea, weakness, headache, sore throat, cough, chest pains, fever, in aprotinin group was 1 -2 days shorter then in Ingavirin group. No side effects neither patient discomfort were revealed in aprotinin group of patients. MDI, containing aprotinin as an active substance, can be recommended as a drug against Influenza caused by different viruses, including seasonal H1 N1, H3N2, swine-like H1 N1 pdmO9, and avian-like H7N9 viruses.
40 ISSN 1816-5095 (print); ISSN 2500-0845 (online) DOI: 10.18008/1816-5095-2017 Результаты лечения первичной открытоугольной глаукомы в сочетании с диабетической ретинопатией цель: оценка эффективности, безопасности гипотензивных препаратов у пациентов с сочетанной патологией -первичной открытоугольной глаукомой (ПОУГ) и диабетической ретинопатией (ДР). Пациенты и методы. Пациенты с ПОУГ I, II, III стадии в сочетании с ДР и диабетическим макулярным отеком (ДМО) были разделены на 3 подгруппы, в зависимости от стадии глауко-мы и вида местной гипотензивной терапии. При ПОУГ I стадии больные получали селективный бета-адреноблокатор (бетофтан 0,5%), при ПОУГ II стадии -комбинацию простагландина (глаупрост 0,005%) и бета-адреноблокатора (бетофтан 0,5%). При ПОУГ III стадии использовали три препарата: простагландин (глаупрост 0,005%), бета-адреноблокатор (бетофтан 0,5%), инги-битор карбоангидразы (дорзопт 2,0%). Лечение ассоциированных ДР, ДМО осуществляли посредством 3 интравитреальных инъекций ингибитора ангиогенеза ранибизумаба. Оценивали динамику клинико-функциональных, гидродинамических показате-лей, морфометрических параметров сетчатки и диска зрительного нерва. результаты. Мониторинг глаукомы показал отсут-ствие значимого повышения ВГД, положительную динамику истинного ВГД, коэффициента легкости оттока и минутного объема водянистой влаги, коэффициента Беккера на фоне применения ранибизумаба с адекватным подбором местных гипотензивных средств (монотерапия или комбинация препаратов). В результате лечения у пациентов с I и II стадиями глаукомы отмечено улуч-шение остроты зрения, периметрических индексов -MD и PSD по Хамфри. Выявлено снижение отека сетчатки, как в макуле, так и в диске зрительного нерва по данным ОКТ-сканирования. заключение: применение ранибизумаба у пациентов с ПОУГ и ДР, ДМО безопасно при корректном подборе гипотензивных средств. ключевые слова: первичная открытоугольная глаукома, диабетическая ретинопатия, диабетический макулярный отек, гипотензивная терапия, ранибизумаб, бета-блокаторы, простагландины, ингибиторы карбоангидразы для цитирования: Воробьева И.В., Мошетова Л.К., Щербакова Е.В. Результаты лечения первичной открытоугольной глаукомы в сочетании с диабетической ретинопатией.
Anthocyanins are known to have antioxidant, anti-inflammatory, neuroprotective, and anticarcinogenic activity as well as positive effect on the cardiovascular system. Because of bilberry anthocyanosides (Vaccinium myrtillus L.), Mirtilene forte promotes rhodopsin synthesis and regeneration, increases retinal sensitivity to changes in light intensity, improves visual acuity and dark adaptation as well as blood supply of the retina. Studies conducted in Russia are aimed at evaluating the use of Mirtilene forte in age-related macular degeneration, diabetic retinopathy, primary open-angle glaucoma, and other diseases. This article provides an analysis of foreign and Russian publications on the effects of anthocyanins and flavonoids in different diseases.
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