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INVENTION
Russian Federation Patent RU2287326
METHOD OF TREATMENT post-traumatic hemorrhage in the eye cavity
Name of the inventor: Fly Alexander (RU); Gundorova Rose A. (RU); Simonenkov Alexey Pavlovich (RU); Fedorov Vladimir Dmitrievich (RU); Mikhail Zinoviev (RU); Verigo Elena (RU)
The name of the patentee: Moscow Research Institute of Eye Diseases. Helmholtz Ministry of Health and Social Development of the Russian Federation (RU)
Address for correspondence: 105062, Moscow, ul. Garden-Chernogryazskaya 14/19, Research Institute of Eye Diseases. Helmholtz, Information Department
Starting date of the patent: 2004.10.27
The invention relates to medicine, in particular to ophthalmology, and can be used to treat post-traumatic hemorrhage in the eye cavity. To do this every day for 10 days administered parenterally 10ml serotonin adipate 0.1% twice a day. The method allows for the rapid resorption streamed into the cavity of the eye blood by the release of serotonin receptors of hemoglobin that allows normalization of the microcirculation in the choroid and retina, with the restoration of the inflow-outflow of intraocular fluid in the cavity of the eye.
DESCRIPTION OF THE INVENTION
The present invention relates to ophthalmology and is intended for the treatment of post-traumatic hemorrhage in the eye cavity. It is known that for the treatment of post-traumatic hemorrhage in the eye cavity currently using fibrinolytics such gemazu (6, 9), YAG - laser vitreolysis (6) surgical removal of a blood extravasated - vitreoectomy (4, 7). However, these treatments often do not provide visual functions, traumatic (especially surgery), and are often expensive.
The object of the proposed method is more efficient in the treatment of post-traumatic hemorrhage eye cavity with the restoration of natural inflow paths - intraocular fluid passing through the vitreous. It is now known that biochemically vitreous is a hydrophilic gel containing 98-99% water. Typically, only 10% of the water in the vitreous are chemically bound state that maintains its high water exchange (3).
It is proved that every 15 minutes, half of the water in the vitreous is replaced by (2). When hemophthalmus, according E.Fuksa (1) in the first days starting haemolysis of blood, red blood cells with hemoglobin lose. The latter circumstance is very important for understanding the pathogenesis of blood resorption of the eye cavity, given: 1) that the vitreous body has antifibrinolytic properties; 2) the aqueous humor is produced constantly choroid (ciliary body); 3) hemoglobin blocks serotonin receptors vascular endothelial (8), which leads to disruption vazomotoriki microvasculature and, obviously, to reduce the formation of intraocular fluid, water metabolism, slow down resorption of extravasated blood, followed by a decrease in visual function that is related to complications hemophthalmus.
Previously conducted their own studies have shown that parenteral or intravitreal erythrocyte autogemolizata leads to chronic serotonin deficiency and retinopathy, which can be explained by hemoglobin blockade of serotonin receptors. At the same time it is known that serotonin in the increased concentration of serotonin receptors may relieve and restore the contractile capacity of the blood vessels of the microvasculature. Considering the above, we have been tasked to develop a method of treating post-traumatic hemorrhage in the eye cavity, using a drug that does not have negative fibrinolytic properties and at the same time able to normalize vasomotions microvasculature - serotonin adipate. The technical result of the invention is the rapid resorption of extravasated blood to the eye cavity, simplifying and cheaper method of treating post-traumatic hemorrhage in the eye cavity.
The technical result is achieved due to the recovery of contractile activity of the microvasculature of the choroid and the normalization of production of aqueous humor from the restoration of a high water exchange vitreous, anterior chamber and then "wash-out" streamed into the cavity of the eye blood by injecting serotonin adipate at a certain concentration. This allows to increase the concentration of serotonin in the blood and tissues, to release hemoglobin from the serotonin receptors, which in turn provides the normalization of microcirculation in the choroid and retina inflow recovery - the outflow of intraocular fluid in the eye cavity and "washing out" of it extravasated blood.
In experimental studies, doses were designed to ensure that the above-mentioned effects. Efficacy in treating post-traumatic hemorrhage eye cavity was evaluated using computed tomography (CT) orbits, 1, 3, 8, 10, 15 hours. Studies were performed on CT tomograph Sytec 3000 Plus (USA), in the frontal and axial projection, with the imager pitch of 3 mm.
Serotonin adipate can be administered as an intramuscular injection or intravenous infusion. Selection Method of administration depends on the patient's veins and technical equipment of medical institutions. The method is as follows.
Serotonin adipate administered daily for 10 days, 2 times a day, 10 mg. When injecting serotonin adipate dissolved in 3.0 ml of 0.5% novocaine. For intravenous infusion, serotonin adipate 10 mg dissolved in 10 ml of isotonic sodium chloride solution, thoroughly mixed, shaken and diluted with 200 ml of isotonic sodium chloride solution.
example 1
On the rock rabbit, "Chinchilla" hemophthalmus obtained by introducing into the vitreous of 0.4 ml of autologous blood unstabilized. Animal 2 received once a day / m adipate 10 mg of serotonin. According to the CT density hemophthalmus 1 day averaged 56 units. AND.; Sizes 4.6 to 1.6 mm, with the fundus reflex is weakened. On the 8th day of the vitreous density equal to + 3-10 ed.N. evenly (the rate corresponding to the density of the vitreous body of the contralateral eye) reflex of the fundus - pink. In the control group (instead of serotonin adipate / m was administered 0.9% phys. Solution) density hemophthalmus on day 1 was + 46-50 ed.N., measures about 4.8 by 2.0 mm. Restoring vitreous density of up to + 3-10 ed.N. (Uniformly) was observed on the 15th day. The results show that the time required for resorption hemophthalmus, in the experimental group is almost twice less than in the control group.
example 2
Patient K., 21 years old. Ds: Contusion right eye moderate, hyphema II degree (3 mm), hemophthalmus. Since the injury (a blow with his fist on the right eye) took 11 hours. Complaints of decreased visual acuity of the right eye, pain in the right orbit, vis OD = 0,3 n / a reflex from the fundus is weakened, vis OS = 1,0. According to CT vitreous density was 74 units. N. (norm 15-25 units AN.); dimensions 5.2 by 2.6 mm. The patient parenterally received 1 ml of 1% solution of serotonin adipate daily for 10 days, 2 times a day by the above method. Hyphema resorption was observed on day 3. Restoring vitreous density to 23 units. N. (normal) were observed on the 11th day of the drug, vis OD = 0,7 n / a reflex from the fundus - pink, vis OS = 1,0. When using a conventional conservative methods of treatment blood resorption occurs from one to several months. Thus, the first to show that parenteral administration course application serotonin adipate (both experimentally and clinically) achieves rapid resorption blood extravasated into the eye cavity, and significantly improve visual function.
USED BOOKS
1. Great Medical Encyclopedia, 1977, v.5, S.235.
2. Same V.6, P.88.
3. The same, 1985, T.24, S.235.
4. Gundorova RA, Verigo EN et al. Traumatic recurrent hyphema and its treatment. // Proceedings of the III Euro-Asian Conf. for ophthalmic surgery. - Ekaterinburg, 2003. - S.157-158.
5. Egorov EA, Astakhov YS, Stavitskaya TV "Oftalmofarmakologiya" // M .: GEOTAR-MED, 2004. - 464 p.
6. AN Ivanov System laser tool of prevention and treatment of the consequences and complications of mechanical eye injury. // Diss .... Doctor. honey. Sciences. - M. - 2003. - 334 p.
7. Romashchenko AD Bykov VP Traumatic recurrent hyphema, pathogenesis and treatment. // Oftalmol. Zh. - 1980. - №8. - S.468-470.
8. Simonenkov AP, Fedorov VD "Is chronic serotonin deficiency basis of diabetic angiopathy and age?". Bull. Exp. Biol. Med., 1997; 123 (1): S.103-110.
9. AV Stepanov, Bolkvadze ER, Belogurov AA et al. Possibilities of treatment of traumatic intraocular bleeding with a new fibrinolytic gemaza. // Vestn. oftalmol. - 2002. - №5. - S.25-27.
CLAIM
1. A method of treating post-traumatic hemorrhage in the eye cavity, wherein the parenterally administered serotonin adipate 10 mg twice a day every day, only 10 days.
2. The method of claim 1, wherein the serotonin adipate injected intramuscularly, while it is dissolved in 3.0 ml of 0.5% novocaine.
3. The method of claim 1, wherein the serotonin adipate administered intravenously by infusion, while serotonin adipate dissolved in 210 ml of saline.
print version
Publication date 06.01.2007gg
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