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An increase in the incidence of optic neuritis among the working-age population, as well as an unpromising prognosis for vision due to the development of optic nerve atrophy, determines the high social significance of this problem. The aim of the work is to analyze the effect of Imunofan at the parameters of cellular immunity and clinical symptoms of the disease in the complex treatment of optic neuritis associated with herpes virus infection. The study involved 37 people (37 eyes) with acute optic neuritis associated with herpes infection. The treatment regimen included the appointment of a dexamethasone solution according to a decreasing scheme, a 1% solution of the drug Emoxipin 0.5 mL and a 12.5% solution of the drug Dicynone 0.5 mL through an irrigation system implanted in the retrobulbar space, in combination with the neuroprotection drugs (Pikamilon and Semax) for 10 days. All patients were divided into 2 groups. The main group consisted of 20 patients who received Imunofan to the treatment regimen in addition. The comparison group included 17 patients who were treated only according to the method described above. The course of treatment lasted 10 days. The analysis of the data showed a more significant positive dynamics of cellular immunity parameters in those who received immunotherapy. Our studies showed the effectiveness of this drug in the complex treatment of optic neuritis associated with herpes infection, what is confirmed by the acceleration of inflammation relief, a more significant increase in visual functions of patients treated with Imunofan, and a lower percentage of optic nerve atrophy. In this group of patients, changes in the parameters of the cellular link of immunity occurred earlier and remained stable throughout the entire period of observation. According to our data, an intergroup assessment of the immunoregulatory index showed its faster increase in patients of the comparison group who received Imunofan, and reached normal values already 6 months after treatment. The clinical effectiveness of Imunofan in the complex therapy of optic neuritis associated with herpes infection was characterized by a reduction in the period of relief of signs of inflammation in the optic nerve by 2 times or more, by an increase in the maximum corrected visual acuity by 4.5 times, and by a decrease in the incidence of recurrence of optic neuritis by 2 times over a 12 months observation period.
An increase in the incidence of optic neuritis among the working-age population, as well as an unpromising prognosis for vision due to the development of optic nerve atrophy, determines the high social significance of this problem. The aim of the work is to analyze the effect of Imunofan at the parameters of cellular immunity and clinical symptoms of the disease in the complex treatment of optic neuritis associated with herpes virus infection. The study involved 37 people (37 eyes) with acute optic neuritis associated with herpes infection. The treatment regimen included the appointment of a dexamethasone solution according to a decreasing scheme, a 1% solution of the drug Emoxipin 0.5 mL and a 12.5% solution of the drug Dicynone 0.5 mL through an irrigation system implanted in the retrobulbar space, in combination with the neuroprotection drugs (Pikamilon and Semax) for 10 days. All patients were divided into 2 groups. The main group consisted of 20 patients who received Imunofan to the treatment regimen in addition. The comparison group included 17 patients who were treated only according to the method described above. The course of treatment lasted 10 days. The analysis of the data showed a more significant positive dynamics of cellular immunity parameters in those who received immunotherapy. Our studies showed the effectiveness of this drug in the complex treatment of optic neuritis associated with herpes infection, what is confirmed by the acceleration of inflammation relief, a more significant increase in visual functions of patients treated with Imunofan, and a lower percentage of optic nerve atrophy. In this group of patients, changes in the parameters of the cellular link of immunity occurred earlier and remained stable throughout the entire period of observation. According to our data, an intergroup assessment of the immunoregulatory index showed its faster increase in patients of the comparison group who received Imunofan, and reached normal values already 6 months after treatment. The clinical effectiveness of Imunofan in the complex therapy of optic neuritis associated with herpes infection was characterized by a reduction in the period of relief of signs of inflammation in the optic nerve by 2 times or more, by an increase in the maximum corrected visual acuity by 4.5 times, and by a decrease in the incidence of recurrence of optic neuritis by 2 times over a 12 months observation period.
Цель-оценить этиологическое значение герпес-вирусной инфекции (ГВИ) у больных с острым идиопатическим оптическим невритом (ИОН) с помощью клинико-лабораторного мониторинга. Материал и методы. Клинико-лабораторные исследования проводились на протяжении 10 лет и базировались на результатах этиологического мониторинга 79 больных (85 глаз) с острым ИОН в период 2005-2015 гг. Результаты. В ходе комплексного обследования 79 пациентов с острым ИОН различные инфекционные патогены были диагностированы у 75 (94,9±2,1%) человек. В их структуре явно доминировала ГВИ (69 (87,3±2,4%) человек). Пациенты были разделены на три этиологические группы. В 1-ю группу вошли 34 человека с герпес-вирусными моноинфекциями, во 2-ю-15 человек со смешанными вирус-вирусными инфекциями, в 3-ю-20 человек со смешанными вирус-бактериальными инфекциями. В общей совокупности обследованных больных с острым ИОН, ассоциированным с ГВИ, чаще встречался вирус простого герпеса-1-более чем в 2,5 раза, реже регистрировались вирус Эпштейна-Барр и цитомегаловирус. Активно текущая ГВИ в общей группе больных диагностирована у 58 (84%) пациентов. При этом отмечалось преобладание (79,7%) реактивации хронической инфекции и крайне редко (4,3%) диагностирована первичная острая ГВИ. У остальных 11 (16%) пациентов была выявлена хроническая персистирующая ГВИ. Заключение. Клинико-лабораторный мониторинг ГВИ у больных с острым ИОН показал этиологическую роль в его развитии герпес-вирусов. На основании комплекса серологических маркеров в реакциях иммуноферментного анализа сыворотки крови установлено, что частота герпес-вирусного инфицирования равна 87,3±2,4%. В общей группе пациентов удельный вес активно текущей ГВИ составляет 84%. Результаты выполненных клинико-лабораторных исследований имеют большое практическое значение для верификации этиологического диагноза и выбора адекватной этиопатогенетической терапии у больных с острым ИОН, ассоциированным с ГВИ. Ключевые слова: идиопатический оптический неврит, герпес-вирусная инфекция, лабораторный мониторинг, серологические маркеры.
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