The Results of the Usage of Electro Stimulation in Neuroprotective Therapy of the Glaucomatous Optic Neuropathy

Abstract

Glaucoma is a chronic progressive optic neuropathy with characteristic morphologic changes in the head of optic nerve and progressive death of retinal ganglion fibers with narrowing of the visual field. Effective decrease of IOP is not able to serve as a guarantee of stabilization of glaucomatous process that continue to progress in part of patients. Thus, a search of a new direction of the drug therapy is needed because of the fact that hypotensive therapy is not completely effective. The most perspective of them is neuroprotection in combination with percutaneous electrostimulation that protect neurons of the retina and nerve fibers of optic nerve from different damage factors.  

Aim. To assess the effectiveness of percutaneous electrostimulation in complex neuroprotective treatment of the glaucomatous optic neuropathy

Materials of the research. The study is based on the results of50 (90 eyes) patients that were examined with GON  in condition with compensate IOP aged 18 to 55 years. Compensation of IOP was reached by  medicinal, laser and surgical ways. All patients were divided into two homogeneous groups depending on the stage of primary open angle glaucoma and age of patients.  In control group 25 (44) eyes took traditional therapy during 10 days in the scheme of which  a preparation « Retinilamine» was included. In the study group 25 (46 eyes)  patients along with traditional therapy took endonasal electrophoresis with preparation of «Tanakan» 1 time per day and percutaneous electrostimulation with a help of ESOM apparatus that based on the usage of a rectangular negative impulse with duration 1-10 ms, following with frequency 5-30 Hz and amplitude 10-1000 µA during the 10 days.  A 4-6 series with 15-45 sec and interval among 30-60 sec were carried out on the each eyeball.

Results. Clinical and functional assessment of the complex treatment of glaucomatous optic neuropathy with injection of preparation “Tanakan” via endonasal electrophoresis in combination with percutaneous electrostimulation according to OCT and computer perimeter findings demonstrate reliable improvement of the average visual field and index of computer perimeter such as МD and  PSD, as well as improvement indications of optical coherence tomography, especially RNFL compare to initial ones and prove effectiveness of the proposed therapy.

Conclusion According to our results, inclusion of endonasal electrophoresis with tanakan following with percutaneous  electrostimulation in complex  treatment of glaucomatous optic neuropathy   has the effect of protecting from detrimental influence of IOP to retina, promotes prolongation of the main treatment and recovery of visual function of the eye. Given method associate with percutaneous electrostimulation has sufficient comfort, cost-effectiveness, fast and stable positive effect and can be used in both inpatient and outpatient condition