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Тhe antiaggregatory therapy of patients with early non-exudative age-related macular degeneration


E.P. Lantuh, M.A. Frolov, P.A. Gonchar, M.V. Zueva, T.N. Kiselyova, E.M. Aldieva, U.I.A. Ahmed

The review paper contains analysis of literature dedicated to various action modes of ASA, possibilities for using this preparation in treatment and prevention of ARMD, positive and negative effects of ASA administration. It has been experimentally proven [13] that ASA is capable of protecting brain cells from toxic and hypoxic hypoxia by inhibiting intracellular ATP reduction in hippocampus cells. ASA interferes with mitochondrial function, blocks glutamate receptors, reduces the level of mitogen-active kinases [17]. Recovery of neuronal function after hypoxia goes on quicker after previous exposure of ASA. ASA is capable of decreasing the level of matrix metalloproteinases (ММР) in human endothelial cells, cultivated in a medium with high glucose content [11], which can neutralize complications connected with development of angiogenesis in diabetes. The review discusses the question of possibility of adverse side effects on retina in long-term administration of moderate and large doses of ASA. In particular, it was proven that in elderly patients ASA can provoke incidence of dry form of ARMD and its transformation into humid form [12]. In patients with neovascular ARMD, a risk of subretinal hemorrhages, which redoubles at bilateral injury, increases in anti-platelet or anticoagulant therapy [9, 10, 15]. On the other hand, it was proven that ASA has a positive effect on ARMD course in combination, for example, with vitamin Е [18] or β-carotene [8, 19]. The analysis of literature allows assuming perspective character of administration of minimum effective doses of ASA (75 mg/day) in a short course of two months or less for treatment of dry form of ARMD, which would allow preventing hemorrhagic complications on the part of eyes and other organs, and on the other hand – preventing ASA adverse effects, associated with long-term administration of larger doses.

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