Оптическая нейропатия и отечный экзофтальм. Новые подходы к лечению

Abstract

Purpose. To study the clinical effectiveness of the administration of complex therapy of drugs to the hemolymphocirculatory organ (pterygopalatine fossa) in edematous exophthalmos in patients with endocrine ophthalmopathy complicated by optical neuropathy. Material and methods. The analysis of the results of treatment of 31 patients (62 eyes) with edematous exophthalmos on the background of endocrine ophthalmopathy complicated by optical neuropathy, who applied for help in the Novosibirsk branch of "MNTC "Eye Microsurgery". All patients were prescribed a 10-day course of intensive complex treatment, consisting of injections into the region of hemolymphocirculation (pterygeal fossa) No. 6 (No. 3 on each side) with an interval of 24 hours of a drug mixture, the formulation of which included Lidocaine 20 mg, Dexazone 4 mg, Hemase 3000 units, Dalargin 1 mg, with additional administration of antioxidants, neuroprotectors, vitamins and keratoprotectors. Results. By the end of treatment, all patients had a pronounced positive trend in the form of a significant (from 0.6 to 1.0) increase in visual acuity, a decrease in exophthalmos (from 2,0 to 3,0 mm), and an increase in color and contrast sensitivity. Conclusions. Due to the violation of venous and lymphatic outflow due to the thickening of extraocular muscles and retrobulbar fiber, injection of drugs with a wide range of decongestant and metabolic effects into the hemolymphocirculation region (pterygeal fossa) is justified and effective. Key words: endocrine ophthalmopathy, optical neuropathy, complex therapy.