Dynamics of clinical and morphofunctional indicators in patients with acute optic vascular neuropathy under the influence of treatment

Background. Vascular pathology of the optic nerve and retina is one of the leading causes of blindness. Diseases caused by circulatory disorders account for 10–15 % of the total number of ocu­lar pathologies. In the nosological structure of eye diseases, leading to irreversible blindness, glaucoma and vascular diseases prevail. In modern ophthalmology, neuroprotection issues are relevant in the treatment of acute vascular optic neuropathy. The purpose was to determine the peculiarities of clinical and morphofunctional indicators in dynamics under the influence of long-term use of sulode­xide in patients with acute optic vascular neuropathy. Materials and methods. One hundred and six patients (106 eyes) with acute vascular optic neuropathy were examined. The course of treatment lasted for 10–12 days. Patients were randomly divided into two groups. Group I consisted of 65 patients, who, after inpatient treatment with sulode­xide, continued to receive the drug for 6 months. Group II included 41 patients, all of them did not receive treatment after completing the inpatient course with sulodexide injections. A clinical and general ophthalmic and morphofunctional examination was carried out. Results. After 6 months of observation, there was an improvement in the best corrected visual acuity (p = 0.000) in both groups. Howe­ver, in group I, it was 2-fold higher compared to group II — 0.3 (0.3–0.5) and 0.14 (0.1–0.2), respectively. Due to the normalization of clinical indicators, the probable risk of developing hypertension after 6 months was 30 % lower in the group of long-term sulodexide use (relative risk 0.43; 95% CI 0.26–0.71) than in patients who did not continue taking the drug orally. Conclusions. The active substance sulodexide is a modern, effective, safe and pathogenetically justified drug for the treatment of patients with acute optic vascular neuro­pathy. To prevent relapses of the disease and restore visual functions, prolonged administration of the drug is required for 6 months to obtain a stable positive effect, both for the normalization of clinical indicators and stabilization of visual functions. The best correc­ted visual acuity increased twice as much in the group of patients taking sulodexide. During the 6-month follow-up, the number of patients with hypertension in group I reduced by 54 % versus 27 % in group II, and the probable risk was 30 % lower than in those who did not continue oral administration of the drug. A significant (p < 0.05) positive correlation was found between the effectiveness and duration of treatment, improvement of clinical indicators, hemodynamics. As a result, blood pressure normalized, and visual functions improved. It was found that the effectiveness of treatment, expressed in the stabilization of visual functions and the condition of patients, was 69 % in the group of long-term sulodexide use after 6 months (versus 44 % in patients who did not take the drug for 6 months). The probable risk of developing optic nerve atrophy within 6 months in the group of long-term sulodexide use was 39 % lower than in patients who did not continue oral administration of the drug.