THE ROLE OF ENDONASAL ELECTROPHORESIS WITH DEXAMETHASONE IN THERAPY OF UVEITIS UNDER CONCOMITANT ANKYLOSING SPONDYLITIS

Abstract

Uveitis is a severe clinical manifestation of ankylosing spondylitis, leading to the loss of vision, particularly among young and working-able individuals. This study aims at evaluating the outcomes of integrated treatment for uveitis in Bekhterev's disease using endonasal electrophoresis with dexamethasone. Materials and Methods. The study included 22 patients (23 eyes) with uveitis and underlying ankylosing spondylitis who received inpatient treatment at Acad. Z. Aliyeva National Centre of Ophthalmology between 2017 and 2022. The average age of the patients was 34 ± 8.7 years, including 5 female and 17 male patients. In the main group, consisting of 12 patients (12 eyes), endonasal electrophoresis with dexamethasone was performed in addition to general and local steroid therapy. The control group comprised 10 patients (11 eyes) who received treatment without physiotherapy. Endonasal electrophoresis was conducted using the "Potok-1" apparatus, with gauze swabs soaked in a 0.4% dexamethasone solution and inserted into the middle nasal passages. The active electrode was secured to the free ends, and the drug was administered from the cathode. A total of 10 procedures were performed, starting from 10 minutes and gradually increasing to 15 minutes. The patients received inpatient treatment for two to three weeks. Results: The patients from main and control groups demonstrated positive dynamics in terms of increased visual acuity and expanded visual fields. Inflammation signs subsided within 4-5 days since the beginning of the treatment in the main group and within 6-7 days in the control group. Clinical improvement was evident in both groups, characterized by hypopion resorption, reduced cell count in the anterior chamber, and decreased opacities in the vitreous body. In the posterior segment, perivascular infiltration, chorioretinal foci, and macular oedema also showed signs of improvement. Conclusion: The use of dexamethasone endonasal electrophoresis as part of the complex therapy for uveitis in ankylosing spondylitis demonstrated more pronounced clinical effects compared to traditional treatments. Positive dynamics were observed in clinical, functional, perimetric, and electrophysiological indicators. Dexamethasone endonasal electrophoresis proved to be well-tolerated by patients and economically viable, making it a valuable addition to the complex therapy of uveitis in ankylosing spondylitis in both inpatient and outpatient settings.