RU-2861704-C1 - METHOD FOR TREATING VASCULOGENIC MACULOPATHY IN POST-COVID PERIOD AT STAGE OF PRECLINICAL DIAGNOSIS

Abstract

FIELD: medicine; ophthalmology. SUBSTANCE: optical coherence tomography with an angiographic mode is performed. If a decrease in the vessel density of the superficial capillary plexus of the parafoveal area below 35.4% and a decrease in the vessel density of the deep capillary plexus of the parafoveal area below 42.5% in all quadrants are detected, treatment is carried out according to the following scheme: for 10 days, daily intramuscular injections of Mexidol solution - 5.0 ml and Pentoxifylline solution - 5.0 ml, Cytoflavin 2 tablets 2 times a day for 1 month, for 5 days daily intramuscular injections of Galavit solution 100 mg - 2.0 ml. Then 15 injections every other day, instillations into both eyes of Exinte 1 drop 3 times a day daily for 14 days. EFFECT: possibility of choosing adequate treatment tactics considering the identified vascular lesions, by determining the sum of morphometric signs characteristic of preclinical vasculogenic maculopathy in patients in the post-COVID period. 1 cl, 2 ex

Inventors

• MYAKOSHINA ELENA BORISOVNA
• Dorofeeva Yana Viktorovna
• Pavlova Olga Valerevna

Dates

Publication Date

20260507

Application Date

20250821

Claims (1)

1. A method for treating vasculogenic maculopathy in the post-COVID period at the preclinical diagnostic stage, characterized in that optical coherence tomography with angiographic mode is performed, and if a decrease in the retinal vessel density of the superficial capillary plexus of the parafoveal zone below 35.4% and a decrease in the retinal vessel density of the deep capillary plexus of the parafoveal zone below 42.5% in all quadrants is detected, treatment is carried out according to the following scheme: daily intramuscular injections of Mexidol solution - 5.0 ml and Pentoxifylline solution - 5.0 ml for 10 days, Cytoflavin 2 tablets 2 times a day for 1 month, daily intramuscular injections of Galavit solution 100 mg - 2.0 ml for 5 days, then 15 injections every other day, instillations of Exinte in both eyes, 1 drop 3 times a day daily for 14 days.

Description

The invention relates to medicine, namely ophthalmology, and can be used to treat vasculogenic maculopathy in the post-COVID period at the preclinical diagnostic stage. In December 2019, the first cases of pneumonia of unknown etiology were recorded in Wuhan City (Hubei Province, People's Republic of China). Epidemiological and molecular genetic studies led to the identification of a new coronavirus, designated SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), in early January 2020. The disease caused by this virus was officially named COVID-19 (Coronavirus Disease 2019) [Worobey M., Levy J.I., Malani A. et al. The Origins of SARS-CoV-2: A Critical Review. Cell. 2022; 185 (5): 812–827.]. The rapid spread of the infection, both within China and beyond, led to a rapid increase in the number of cases. Consequently, on March 11, 2020, the World Health Organization officially declared the outbreak a pandemic, recognizing the global nature of the threat and the need for a coordinated international response [Federal COVID-19 Monitoring Portal in Russia, https://coronavirus-control.ru/coronavirus-russia/] Over time, it became clear that patients who had recovered from COVID-19 for a long time presented with various complaints such as asthenia, loss of appetite, shortness of breath, and other symptoms. As a result, in June 2020, the term "long-COVID" or "post-COVID syndrome" began to be used in medical publications and gained recognition in the scientific community. In Russia, the term "post-COVID syndrome" is used in medical practice to describe a condition in which patientsVarious symptoms persist after COVID-19. Russian specialists note that the mechanisms contributing to the development of nervous system pathology in COVID-19 can also be explained by the direct effect of the virus and neuroinflammation, severe systemic inflammation, microvascular thrombosis and neurodegeneration with healing of systems and organs, including the organ of vision [Filonenko I.V., Dorofeeva Ya.V., Myakoshina E.B. Analysis of the optic disc and the macular ganglion cell complex using optical coherence tomography in patients in the post-COVID period. Ophthalmology. 2025; 22 (2): 391-397; Kurysheva N.I., Evdokimova O.A., Nikitina A.D. Visual organ damage in COVID-19. Part 2: complications in the posterior segment of the eye, neuro-ophthalmological manifestations, vaccination and risk factors. Russian: Russian Ophthalmological Journal. 2023;16(1): 157-167.]. While there is no convincing evidence of SARS-CoV-2 infection of neurons, this virus can cause changes in the brain parenchyma and blood vessels, apparently by acting through the BBB and causing inflammation in neurons vascularized by cerebral vessels. The pathophysiological mechanisms of long-COVID, such as immune dysregulation, autoimmune processes, systemic inflammation, and dysfunction of the autonomic nervous system, are being actively studied. [Vinci R, Pedicino D, Andreotti F, Russo G, D'Aiello A, De Cristofaro R, Crea F, Liuzzo G. From angiotensin-converting enzyme 2 disruption to thromboinflammatory microvascular disease: A paradigm drawn from COVID-19. Int J Cardiol. 2021; l;326:243-247.] The mechanisms of long-COVID development are being actively studied in Russia and abroad. In particular, researchers identify the following pathophysiological processes: immune dysregulation and autoimmune mechanisms, systemic inflammatory response syndrome, impaired hemostasis and vasculopathy, direct cytotoxic effect of the virus on cells and long-term viral persistence, autonomic, nervous, endocrine and metabolic dysfunction [Neroev VV, Kiseleva TN, Eliseeva EK Ophthalmological aspects of coronavirus infection. Russian Ophthalmological Journal. 2021; 14(1):7-14., Amadoro G, Latina V, Stigliano E, Micera A. COVID-19 and Alzheimer's Disease Share Common Neurological and Ophthalmological Manifestations: A Bidirectional Risk in the Post-Pandemic Future. Cells. 2023; 10; 12(22):2601.]. Patients after COVID-19 often experience unexplained visual discomfort, limited physical activity, decreased performance and quality of life [Filonenko I.V., Myakoshina E.B., Dorofeeva Ya.V., Pavlova O.V. Visual perception and quality of life in the post-COVID period. Effective pharmacotherapy. 2025; 21 (6): 18-23.13]. A unique advantage of the retinal vascular system is that it can be studied in vivo compared to the vascular systems of other organs. Studying retinal microvascular damage during SARS-CoV-2 infection is of great importance, as it may indicate vascular damage in other organs. Thus, optical coherence tomography is becoming a valuable clinical tool. Retinal microvascular and choroidal vascular damage by the SARS-CoV-2 virus can be a medium- or long-term process. This has implications for follow-up and identification of short- and long-term consequences that may occur in patients with COVID-19 [Wang S, Wang J, Hu J, Wang N. Retinal microvascular impairment in COVID-19 patients: A meta-a