玻璃体注射胰岛素治疗青光眼神经退行性治疗的临床研究

A. C. Boudghene
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摘要

目的:研究玻璃体注射胰岛素治疗青光眼神经变性的有效性和安全性。方法:招募11例患者(11只眼),双盲随机对照10例,其中5例接受1次iv注射3UI, 5例接受1次平衡盐溶液(BSS) 3UI。通过光学相干层析成像(OCT)和视野成像(VF)进行了为期168天的随访。第11例患者连续2次注射IIV,每次注射间隔1个月内未遮盖注射内容,随访877天。所有患者眼压正常,未停止眼科治疗。结果:5例患者接受IIV治疗后,分贝(DB)迅速改善,并在第一个月内保持稳定。168天平均改善6.62DB。5例患者1次注射BSS治疗后无明显改善。45分贝。最后接受两次注射的患者从7.54DB增加到17.22DB,功能改善了9。68分贝。OCT检查在第一个月显示结构改善,然后恢复到初始值。治疗期间及治疗后均无并发症发生。结论:胰岛素不仅具有疗效和安全性,而且在所有随访中,患者的视野(VF)稳定且无恶化,证实胰岛素的作用是改善功能而非结构。这意味着胰岛素重新连接气孔并改善神经突的生长,这种治疗将改变这种病理的演变,并保护青光眼患者免于失明。
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Clinical Study of Neurodegenerative Treatment on Glaucoma by Insulin Intravitreal Injection
Purpose: Our trail was to study insulin intravitreal injection’s (IIV) efficacity and safety to treat glaucoma neurodegeneration. Methods: Eleven subjects (11eyes) were recruited;10 patients treated in a double masked randomized sham controlled including 5 patients received one IIV injection 3UI and 5 patients received one injection of balanced salt solution(BSS) 3UI. A follow up during 168days was realized using Optical Coherence Tomography(OCT) and visual field(VF).The eleventh patient received two IIV injection without masking the injection content within one month between each injection and followed up for 877days.All the patients have a correct ocular pressure and no ocular treatment was stopped. Results: The 5 patients who received IIV revealed a swift improvement of decibel (DB), and remains stable during the first month. The average improvement was 6.62DB during 168days.The 5 patients treated with one BSS injection showed no significant improvement regaining 1. 45DB.The last patient who received two injections showed increase from 7.54DB to 17.22DB with a functional amelioration of 9. 68DB.The OCT examination showed a structural improvement during the first month, then returned to the initial value. No complication was observed during and after the treatment. Conclusion: Insulin shows not only efficacity and safety but more than that, the visual field(VF) of the patients became stable and show no deterioration in all the follow up, which confirmed that insulin act to improve the function rather than structure. it means insulin reconnect the stoma and improve the neurite outgrowth This treatment will change the evolution of this pathology and protect the glaucomatous patients against blindness.
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