Comprehensive Treatment Plan for Idiopathic Neurovasculitis

Author:

Usenko V.1,Umetalieva M.2ORCID

Affiliation:

1. Kyrgyz State Medical Institute for Retraining and Advanced Training named after S. B. Daniyarov

2. Salymbekov University

Abstract

Goal is to develop a comprehensive treatment plan for patients with idiopathic retinovasculitis, taking into account etiopathogenetic and clinical data from the retina. 86 patients (172 eyes) with retinal angiitis of idiopathic genesis were examined and were subject to treatment. The average age of the patients was 22.0 ± 0.17. Clinical forms of retinal changes: angioretinopathy — 16 eyes, 8 patients — 9.3%; neuroretinopathies — 104 eyes, 52 patients — 60.5%; neurovasculitis — 24 eyes, 12 patients — 14%; retinal angiopathy — 28 eyes, 14 patients — 16.2%. According to the severity of fundus changes: mild — 33 patients (66 eyes) — 38.4%; average — 30 patients (60 eyes) — 34.9%; severe — 23 patients (46 eyes) — 26.7%. The special methods of examining patients included: autoperimetry, eye biomicroscopy, direct and reverse ophthalmoscopy, OST of the optic nerve disc and macula, autofluorescent OCT of the retinal vessels, and optic disc with calibrometry, ultrasound dopplerography of the retinal vessels. The main principles of the therapy: 1. Suppression of immune inflammation in the acute phase and in the relapsing phase (treatment with HA, the appointment of immunosuppressants and immunostimulants in a prolonged course). 2. Correction of hemostasis and hemocirculatory disorders in the vessels of the retina. 3. Drug, symptomatic therapy and surgical treatment. Discussion of treatment results: Significant increase in visual acuity: in angioretinopathy from 0.45±0.24 to 0.9±0.14 (P <0.01); with neuroretinopathies from 0.34±0.2 to 0.85±015 (P <0.01); with concomitant maculopathy from 0.44±0.2 to 0.7±0.23 (P <0.01) and macular degeneration from 0.02±0.063 to 0.3±0.24 (P <0.05). There was an increase in visual acuity after treatment with a severe degree from 0.02±0.054 to 0.3±0.24 (P<0.05), with an average - from 0.5±0.24 to 0.9±0.13 (P<0.01), with mild — from 0.7±0.23 to 1.0±0.10. A significant decrease in the frequency of retinal changes after treatment was revealed: angioretinopathies up to 3.5% versus 9.3%; neuroretinopathies up to 11.6% versus 60.5%; maculopathy up to 8.7% versus 26.2%. The effectiveness of the treatment is due to the normalization of indicators of the immune status and hemocirculatory disorders in the retinal vessels according to calibrometry data. Thus: Complex treatment aimed at the main pathogenetic links in the development of idiopathic retinovasculitis contributes to the relief of pathological processes, reduction of complications, and eye disability.

Publisher

Publishing Center Science and Practice

Subject

General Medicine

Reference19 articles.

1. Ермакова Н. А. Клиника, этиопатогенез, лечение ангиитов сетчатки: автореф. дисс. … д-ра мед. наук. М., 2004.

2. Астахов Ю. С., Тульцева С. Н. Этиологические факторы развития тромбоза вен сетчатки у пациентов молодого возраста // Регионарное кровообращение и микроциркуляция. 2004. Т. 3. №4. С. 39-42.

3. Насонов Е. Л., Баранов А. А., Шилкина Н. П. Васкулиты и васкулопатии. Ярославль: Верхняя Волга, 1999. 612 с.

4. Лыскина Г. А. Системные васкулиты // Детская ревматология: Рук. для врачей. М.: Медицина, 2002.

5. Emmi, G., Silvestri, E., Squatrito, D., Amedei, A., Niccolai, E., D’Elios, M. M., ... & Prisco, D. (2015). Thrombosis in vasculitis: from pathogenesis to treatment. Thrombosis journal, 13(1), 1-10. https://doi.org/10.1186/s12959-015-0047-z

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3