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Management of talc retinopathy in addicts on crushed tianeptine tablets solution
Author(s) -
BARDEEVA J,
RYABTCEVA A
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.270.x
Subject(s) - medicine , ophthalmology , visual acuity , neovascularization , laser coagulation , retinal , macular edema , retina , optic nerve , retinopathy , surgery , diabetic retinopathy , diabetes mellitus , angiogenesis , physics , optics , endocrinology
Purpose Description of retinopathy among drug addicts using intravenous mortars from the crushed tianeptine tablets appeared in Russia since 2006. Methods 11 patients were treated. In all patients there was a decrease in visual acuity of both eyes, less than 10/100. In 7 patients neoangiogenesis retina of both eyes was revealed, 4 of those were complicated by intravitreal hemorrhages and iris rubeoz. 1 male had peripheral, others ‐ central neovascularization including of the optic disk. The follow up period was about 2 years.In patients referred during first month of decreasing visual acuity no ophthalmoscope signs оf proliferation and angiogenesis was noted. Fluorescent angiography identified total violation of perfusion of the retina. That was argument for laser photocoagulation. Laser treatment had being done within 4 months, consisted in application of 1600‐2600 spots 300‐500 mkn. Blockers VEGF had been used in the cases of neovascular glaucoma. Vitrectomy was the last chance in cases with tractional retinal detachment and hemophthalm. Results The stabilization of process was achieved in patients with early retinopathy during the of laser coagulation before development newly formed vessels. As a result of early treatment a complete resorbtion of macular edema by 6 months with a gradual atrophy nerve fiber layer according to the OCT. Visual acuity was maintained the same as at the first referral. Benefits of panretinal laser photocoagulation in cases of retinal neovascularization and optic nerve is doubtful, positive dynamics was not observed. Conclusion Retinopathy as a result of intravenous оf crushed tianeptine solution use is similar to talc retinopathy.Early laser treatment can be recommended before proliferation occur.