Abstract
To this date nonsteroidal anti-inflammatory drugs play a huge role in the treatment of inflammatory eye diseases. Ophthalmologists face the question of choosing between glucocorticoid drugs (GCS) and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of any inflammatory process. At the same time, these groups can be used both in combinations and in monotherapy mode. Glucocorticoids are widely and effectively used in ophthalmology, but it should be remembered about a number of serious side effects of this group of drugs. When using these drugs, it is possible to increase ophthalmotonus, decrease the immune response and reparative processes, also GCS have cataractogenic and ulcerogenic effects, and therefore it careful use is necessary. NSAIDs are inferior to glucocorticoids in anti-inflammatory activity. Its mechanism of action is associated with blocking cyclooxygenase, inhibition of prostaglandin synthesis from arachidonic acid. In this regard, NSAIDs are the preferred group in the treatment of inflammatory eye diseases. The use of NSAIDs gives a good analgesic effect, this class of drugs is effective for the prevention of macular edema of various etiologies and reducing the risk of inflammation in the postoperative period. One of the most effective and most modern NSAIDs for topical use is a derivative of phenylacetic acid — Bromophenac, which in its formula has a bromine atom, which increases its lipophilicity, penetrating ability into the tissues of the eye, as well as analgesic and anti-inflammatory activity. Bromfenac is effective for relieving pain and all signs of inflammation caused by disease or surgery, suppressing the development of macular edema of various etiologies, has an antimiotic effect. Also, this group can be used after refractive surgery to reduce pain and photophobia, to relieve itching in allergic conjunctivitis. Double use of this drug during the day, the absence of discomfort and minimal side effects contribute to improving the patient’s compliance.
Highlights
Воспаление — патологический процесс, который возникает в ответ на повреждение тканей или действие патогенного раздражителя
После действия повреждающего фактора происходит нарушение целостности клетки, высвобождение из ли‐ зосом фосфолипазы и ее активация
Что «золотым стандартом» при лечении воспалительных заболеваний глаз являются кортикосте‐ роиды
Summary
После действия повреждающего фактора происходит нарушение целостности клетки, высвобождение из ли‐ зосом фосфолипазы и ее активация. Далее фосфолипаза активирует каскад арахидоновой кислоты, что запускает цикл оксигеназ — циклооксигеназы-1 (ЦОГ-1) и цикло‐ оксигеназы-2 (ЦОГ-2) с высвобождением простаглан‐ динов, простациклинов и тромбоксанов, наряду с этим происходит запуск цикла липооксигеназы и дальнейшее высвобождение лейкотриенов Простагландины, в свою очередь, действуют на болевые рецепторы, повы‐ шая их чувствительность, и сосуды, вызывая экссудацию. Воспалительный процесс в глазу происходит следу‐ ющим образом. При увеличении концентрации белка в передней камере глаза происходит повышение внутри‐ глазного давления, нарушается гематоофтальмический барьер, действие цитокинов вызывает миоз и вазодила‐ тацию
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