ENTER


Полный размерЗакрыть

Our Results of the Use of Direct Neuroprotection in the Complex Treatment of Glaucomatous Optical Neuropathy in Patients with Primary Open-Angle Glaucoma from 2011 to 2019

Details
Written by Super User
Category: #2 (10) 2019
Published: 28 December 2019
Hits: 1562


https://doi.org/10.30702/Ophthalmology.2019/10.1487106

Serdiuk V.1, Ustymenko S.2, Kushnir N.2, Maksymova I.2

1Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine, Dnipro, Ukraine

2Dnipropetrovsk Regional Ophthalmological Clinical Hospital, Dnipro, Ukraine

 

Abstract

Materials and methods. Under observation, there were 64 patients (106 eyes) aged 59 to 79 years; of which 39 are men and 25 are women. Depending on the stage of primary open-angle glaucoma (POAG), patients are divided into two groups that are comparable by age, gender and clinical condition – 34 patients (53 eyes) with 2 stages of POAG and 30 patients (53 eyes) with 3 stages of POAG. A prerequisite for inclusion in the study is the stabilization of IOP.

As direct neuroprotection drugs, citicoline and memantine were used.

To assess the course of the neurodegenerative process for the period from 2011 to 2019 The perimetric indices of MD and PSD, morphological characteristics according to optical coherence tomography – Vrim, GCC, GLV, FLV, as well as latency and amplitude of the early components of visual evoked potentials were analyzed.

Results. The highest efficiency of direct neuroprotection was found for stage 2 of POAG with monotherapy with citicoline, and for stage 3 of POAG with combination therapy with citicoline and memantine. At long-term follow-up, the results of neuroprotective monotherapy with memantine were practically the same as traditional treatment. The obtained results demonstrated a slowdown in the progression of glaucomatous optical neuropathy in all objective indicators by 2–2.5 times in patients who received combined neuroprotective therapy – citicoline and memantine, compared with patients who received conventional therapy.

Keywords: рrimary open-angle glaucoma, neuroprotection, optiс neuropathy, citicoline, memantine.


REFERENCES

  1. Joo CK, Choi JS, Ko HW. Necrosis and apoptosis after retinal ischemia: involvement of NMDA-mediated excitotoxicity and p53. Invest. Ophthalmol. Vis. Sci. 1999;40:713–20.
  2. MacInnis B, Campenot R. Regulation of Wallerian degeneration and nerve growth factor withdrawal-induced pruning of axons of sympathetic neurons by the proteasome and the MEK/ Erk pathway. Mol. Cell. Neurosci. 2005;28:430–9.
  3. Serdiuk VN, Semenko VV. [Influence of the light irradiation in the state of the lipid peroxidation processes in the eye tissues in modeling primary glaucoma]. J.ophthalmol. 2011;1:65–9. Ukrainian.
  4. Serdiuk V. [Study of the Cycle of Neurotoxic Transmitter – Glutamate in the Retina in Experimental Glaucoma]. J.ophthalmol. 2012;2:58–63. Ukrainian.
  5. Carter-Dawson L, Crawford ML, Harwerth RS, et al. Vitreal glutamate concentration in monkeys with experimental glaucoma. Invest. Ophthalmol. Vis. Sci. 2002;43:2633–7.
  6. Guo L, Salt TE, Maass A, et al. Assessment of neuroprotective effects of glutamate modulation on glaucoma-related retinal ganglion cell apoptosis in vivo. Invest. Ophthalmol. Vis. Sci. 2006; 47:626–33.
  7. Harada T, Harada C, Nakamura K, et al. The potential role of glutamate transporters in the pathogenesis of normal-tension glaucoma. J. Clin. Invest. 2007;117(7):1763–70.
  8. Abu-Amero KK, Morales J, Bosley TM. Mitochondrial abnormalities in patients with primary open-angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2006;47:2533–41.
  9. Secades JJ. Citicoline: pharmacological and clinical review, 2010 update. Rev. Neurol. 2011;52 (Suppl 2):S1–S62.
  10. Sobrado M, López MG, Carceller F, et al. Combined nimodipine and citicoline reduce infarct size, attenuate apoptosis and increase bcl-2 expression after focal cerebral ischemia. Neuroscience. 2003;118(1):107–13.
  11. European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 1. British Journal of Ophthalmology. 2017;101:1–72.
  12. Gnezdeckiy VV, Korepina OS. [Atlas on evoked potentials (practical guide based on analysis of specifc wedges scientifc observations)]. Ivanovo;2011.
  13. Shamshinova AM, Volkov VV. [Functional research methods in ophthalmology]. Moscow; 1999.
  14. Odom JV, Bach M, Brigell M, et al. ISCEV standard for clinical visual evoked potentials (2009 update). Doc. Ophthalmol. 2010;120(1):111–9.
  15. European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Chapter 3: Treatment principles and options. British Journal of Ophthalmology. 2017;101: 130–95.
  16. Osborne NN. Recent clinical findings with memantine should not mean that the idea of neuroprotection in glaucoma is abandoned. Acta Ophthalmol. 2009;87(4):450–4.

Received: 25 Sep. 2019

Published: December 2019