Efficacy of complex neuroprotection in glaucomatous optic neuropathy
Journal Title: Офтальмологический журнал - Year 2018, Vol 0, Issue 5
Abstract
Background. The problem of glaucomatous optic neuropathy is not solved regardless the fact that intraocular pressure is stabilized. To manage the glaucomatous process, effective neuroprotection of the ganglion cells is required. The purpose of the paper was to study the efficacy of complex neuroprotection in patients with glaucomatous optic neuropathy using sequential laser radiation of the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy. Material and Methods. We followed up 27 patients (43 eyes) with advanced open angle glaucoma, verified glaucomatous optic neuropathy (GON), and stabilized intraocular pressure (IOP). The patients’ age averaged 63.8 (SD; 6.8). A treatment course included 10 every-day sessions of laser stimulation (LS) using a SM-4.3 unit (wavelength, 650 nm; irradiance, 0.4 mW/cm2; treatment timing, 240 s on the papillomacular bundle) and additional directed laser radiation to the optic disc (OD) using a 90 D lens (treatment timing, 60 s). Thereafter, patients received a vitamin supplement with 1 mg resveratrol: one capsule daily for 6 months. Results. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol in patients with glaucomatous optical neuropathy made it possible to increase visual acuity from 0.65 to 0.82 (by 26%), to increase visual system sensitivity with phosphene current threshold decreased from 84.9 μA to 76 μA (by 10%), to improve ocular blood circulation from 2.4 to 2.6‰ (by 8%), to decrease vasospasm from 26.7 to 21.8% (by 18%), significantly increase overall retinal light sensitivity from 1395.0 to 1709.0 dB (by 23%), and to stabilize the glaucomatous process within six months. Analyzing the data obtained after a neuroprotective LS course with a subsequent vitamin antioxidant supplementation therapy with reseratrol (1 mg) revealed an apparent correlation between an increase in overall light sensitivity of the retina and an increase in the blood circulation in the eye (rs=0.71, р<0.01) as well as a decrease in threshold current of visual system sensitivity (rs=-0.84, р<0.01). Conclusions. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol (1 mg) in patients with glaucomatous optical neuropathy contributes to: an increase in visual acuity by 26%; an increase in the visual system sensitivity, evidenced by a decrease of phosphene threshold current by 10%; an improvement in ocular blood flow by 8%; a decrease of intraocular vasospasm by 18%; and a significant decrease in overall retinal light sensitivity by 23%. It also supports: an increase in conduction of optic nerve fibers; an improvement of the papillomacular bundle function; and stabilization of the glaucomatous process withing six months.
Authors and Affiliations
O. Guzun, N. Khramenko, S. Slobodianyk, V. Ponomarchuk
On the role of lipid metabolism and lipid peroxidation in the development of retinal disorders in type 2 diabetic rats with myopia
Background. There are current data on the role of dyslipidemia and enhanced processes of lipid peroxidation (LPO) in the pathogenesis of diabetic retinopathy (DR). However, pathogenic mechanisms which can explain the lin...
Predicting the development and progression of primary open-angle glaucoma based on the determination of GST gene polymorphisms
Background: Epidemiological studies have demonstrated that primary open-angle glaucoma (POAG) is a complex multifactorial disease resulting from interaction of risk factors and gene polymorphisms. Previously, we have dem...
Efficacy assessment of treatment of patients with stage III primary open-angle glaucoma using a combined method (phosphene electrical stimulation and photomyostimulation)
The purpose: to assess the efficacy of a combined method, including phosphene electric stimulation (FES) and photomyostimulation, in treatment of patients with stage III primary open-angle glaucoma (POAG) with compensate...
Surgical management of bilateral congenital coloboma of the iris and congenital cataract
Background. A combined character of a defect, which is congenital coloboma in the presence of congenital cataract, brings up an issue of choosing optimal management to achieve the maximum possible optical functions, prov...
Comparison of intravitreal ranibizumab and aflibercept in patients with choroidal neovascularization in pathologic myopia
Purpose. To compare the efficacy of ranibizumab and aflibercept treatment of patients with choroidal neovascularization (CNV) in pathologic myopia. Material and Methods. This was a comparative, uncontrolled, prospective...