Способы повышения эффективности медицинской реабилитации пациентов с острой ишемической нейрооптикопатией

Abstract

Purpose. To study the effectiveness of complex pathogenetically directed treatment of patients with anterior ischemic neuroopticopathy (AIN), including the use of Sulodexide and intermittent retrobulbar infusion of neuroprotective drugs in combination with cranio-orbital magnetic stimulation. Material and methods. 21 patients with the acute phase of AIN aged 37 to 67 years (mean 52.3 ± 4.5 years). Depending on the features of the additions to the ongoing complex therapy, the patients were divided into two groups: the main group (10 people), the treatment regimen of which additionally included the appointment of sulodexide during and after the end of inpatient treatment, and the comparison group (11 people) – with inpatient treatment with sulodexide was not prescribed, and after that the drug Pikamilon was prescribed. The results of treatment were evaluated according to the data of visometry with maximum correction of visual acuity, static perimetry with determination of the total number of cattle in the central field of view, visual evoked potentials (VEP). All studies were performed upon admission of patients to inpatient treatment and after its completion, and then after 3, 6 and 12 months. Results. The therapeutic effect of complex therapy, including the appointment of sulodexide and subtenon infusion of neuroprotectors into the retrobulbar space in patients with AIN in comparison with the comparison group, was expressed as a 1.5-fold increase in visual acuity, a 1.6-fold decrease in the number of absolute and relative 1.35 times the amplitude and a 1.2-fold decrease in the VEP latency. Conclusion. The results of clinical observations showed an increase in the potential for restoration and preservation of the viability of the optic nerve axons in acute AIN using subtenon infusion of neuroprotective drugs into the retrobulbar space and the use of Sulodexide compared with treatment methods without the use of sulodexide. Keywords: acute ischemic neuroopticopathy, neuroprotection, sulodexide, cranio-orbital magnetic stimulation.