Structural and Functional Criteria of Neuroprotection Effectiveness after Anti-VEGF Therapy in Patients with Neovascular Age-Related Macular Degeneration
| Autor: | N. S. Zhajvoronok, V. V. Egorov, G. P. Smoliakova, L. P. Danilova, L. P. Emanova, D. A. Povalyaeva |
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| Jazyk: | ruština |
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Oftalʹmologiâ, Vol 16, Iss 4, Pp 508-514 (2019) |
| Druh dokumentu: | article |
| ISSN: | 1816-5095 2500-0845 |
| DOI: | 10.18008/1816-5095-2019-4-508-514 |
| Popis: | Purpose. Estimate of clinical efficacy of combined use of aflibercept and meldonium at tachyphylaxis of neovascular age-related macular degeneration (nAMD) to ranibizumab. Patients and methods. Comparative analysis of treatment results of nAMD in 25 eyes (25 patients) aged from 52 to 79 years was carried out. Main criterion for the patients inclusion was presence of nAMD resistant to intravitreal injections (IVI) of VEGF inhibitor ranibizumab with visual acuity values of not less than 0.1. Patients with different ophthalmologic pathology, accompanied by development of macular edema, with glaucoma and after any eye operations, performed during study period, were excluded from study. Before using aflibercept, all patients were treated with ranibizumab for 1.5–2 years (from 5 to 7 injections). The lack of persistent positive result was cause for change of course treatment of this patients on aflibercept (3 monthly injections) for enhance anti-vasoproliferative effect. The patients were divided into two groups — main and comparison, comparable by sex, age, visual acuity and type of choroidal neovascularization. In the main group, 3 aflibercept IVI were supplemented parabulbar injections of 0.5 ml of meldonium (with concentration of 500 mg / 5 ml) daily for 10 days. Patients of the comparison group did not receive meldonium. Results. The supplement of meldonium in the main group, relative to the comparison group, led to increase in 1.5 times of best corrected visual acuity, in 1.2 times of b-wave amplitude of the electroretinogram, preservation of the neuro- and pigment epithelium of retina, complete regression of neovascularization. Conclusion. Findings results evidence about clinically advisable to use meldonium in course treatment in patients with nAMD, resistant to ranibizumab, with aflibercept IVI for increase visual functions and stabilize the degenerative changes in neurosensory retina, pigment epithelium and choriocapillary layer. |
| Databáze: | Directory of Open Access Journals |
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