Digest: Kamenskikh 2012 — Transcranial Magnetic ± Laser Therapy in POAG with Cerebral Ischemia
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Clinical takeaway: In 317 glaucomatous eyes (184 patients) with chronic cerebral ischemia, combined transcranial magnetotherapy with either laser or electrostimulation produced the strongest benefits — wider visual fields, fewer scotomas, stronger VEPs, and better ocular blood flow — compared to magnetotherapy alone.
Summary:
This trial compared three physiotherapy methods in POAG complicated by cerebral ischemia:
- Magnet + laser
- Magnet + electrostimulation
- Magnet at cervical sympathetic ganglia
All groups improved, but Groups 1–2 (laser or ES) showed the most pronounced and consistent gains. Patients demonstrated visual field expansion, scotoma reduction, improved VEP amplitude/latency, and better ocular perfusion. Cognitive measures (memory, anxiety, depression) also improved, reflecting systemic neurovascular effects.
The key point is neurovascular synergy: nerve conduction and blood supply improved together. While tested in POAG, these vascular-driven mechanisms are relevant to other ischemic or neurovascular optic-nerve conditions.
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Data & Methods
- Design & Population: 184 patients (317 eyes), ages 58–76, stages I–III POAG with chronic cerebral ischemia.
- Groups:
- Group 1 (91 eyes): Magnetotherapy + dynamic laser
- Group 2 (129 eyes): Magnetotherapy + electrostimulation
- Group 3 (97 eyes): Magnetotherapy to cervical sympathetic ganglia
- Protocol: Daily, 10 sessions × 20 min
Outcomes:
- Visual fields: Expanded in all groups; scotomas reduced/disappeared in up to 65% of early-stage cases (Groups 1–2), ~30% in Group 3.
- Electrophysiology:
- VEP amplitude ↑ 20–35% (strongest in early POAG, Groups 1–2)
- VEP latency ↓ ~10%, most consistent in advanced stages
- Hemodynamics (PSCA):
- Systolic velocity ↑ 15–32%
- Diastolic velocity ↑ up to ~80% in some subgroups
- Resistance index ↓ 10–30%
- Cognitive/Emotional: Improved memory and sleep; reduced anxiety/depression scores in combined arms
Notes: Combined magnet + laser or electrostimulation gave the most pronounced neurovascular synergy. Cervical magnetotherapy was beneficial but less effective overall.
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