Application of pharmaco-physiotherapeutic technologies to improve local light sensitivity in inflammatory optic neuropathy

Abstract

In different years, various groups of drugs, including in combination with physiotherapeutic methods (laser, electrical and magnetic stimulation, electrophoresis with various drugs), were used to treat patients with optic neuropathies. However, no significant results have been achieved so far, and the issue of developing and applying complex pharmaco-physiotherapeutic programs that include two or more factors to potentiate the effects and increase the treatment efficacy remains relevant. Objective: to study in a comparative aspect the effect of transcranial magnetic-electrical stimulation and endonasal electrophoresis with the neuroprotective drug «Semax» 0.1 % and an extended complex, including oxybarotherapy in alternation with inhalation of the helium-oxygen mixture «Heliox 21» and acupuncture, on local light sensitivity in patients with inflammatory optic neuropathy. Material and research methods. The study included 71 patients (142 eyes) with a verified diagnosis of inflammatory optic neuropathy. The patients were divided into 3 groups comparable in terms of clinical, functional, gender, and age characteristics: the main group included 23 people (46 eyes) who had a course of extended neuro-ophthalmic stimulation, consisting of transcranial magnetic-electrical stimulation, endonasal electrophoresis with the neuroprotective drug «Semax» 0.1 %, oxybarotherapy alternating with inhalation of helium-oxygen mixture «Heliox 21», and acupuncture; control group 1 included 24 patients (48 eyes) who underwent a course of transcranial magnetic-electrical stimulation and endonasal electrophoresis with the Semax neuroprotective drug; control group 2 included 24 patients (48 eyes) who were prescribed basic therapy, including a vitamin complex Berocca for 3 months, then a break of 1 month, and repeated courses with an alternation of 3:1, which served as a background in the main group and control group 1. Results. Under the influence of an extended course of complex physiotherapy, more significant and lasting results were obtained in the form of an increase in indicators of the threshold of light sensitivity both in the best and in the worst eye, which persisted throughout the entire follow-up period (up to 48 weeks). By comparison, when using a course of physiotherapy, including transcranial magnetic-electrical stimulation and endonasal electrophoresis with a neuroprotective drug «Semax» (control 1), the efficiency was significantly lower, and significant positive dynamics was noted only in the worst eye, it was less pronounced and persisted for up to 24 weeks. Conclusion. Using the course of extended neuro-ophthalmic stimulation in patients with inflammatory optic neuropathy, including transcranial magnetic-electrical stimulation, endonasal electrophoresis with the neuroprotective drug «Semax» 0.1 %, oxybarotherapy in alternation with inhalation of helium-oxygen mixture «Heliox 21», and acupuncture, contributes to an increase in the threshold light sensitivity in both the best and worst eye and its long-term preservation during the entire follow-up period (up to 48 weeks).