Results of a clinical study on the effectiveness of azapentacene in the treatment of early senile cataract

Purpose of the study is to evaluate the effectiveness of azapentacene in preventing the progression of early senile cataract based on a comprehensive assessment of clinical indicators, as well as biomechanical and tomographic parameters of the lens.

Material and methods. 30 patients (58 eyes) with initial senile cataract were examined. The azapentacene was used in the form of eye drops (3–5 times a day, instillation into the conjunctival cavity). In these eyes the parameters of the lens layers were studied using optical biometry, sonoelastography, and acoustic density. A comparative analysis of clinical indicators, biomechanical and tomographic parameters of the lens was carried out before the start of therapy and three months after its start. The functional state of the visual system uncorrected (UCVA) and maximally corrected (BCVA) visual acuity, computer perimetry data and the characteristics of the lens, based on a biomicroscopic examination using the LOCS III classification, were evaluated in 57 eyes.

Results. A significant improvement in visual acuity was noted in the study group. UCVA increased from 0.39 ± 0.04 to 0.44 ± 0.04 (p < 0.001), and BCVA from 0.91 ± 0.02 to 0.93 ± 0.02 (p < 0.001). Analysis of computer perimetry data showed a significant increase in sensitivity: MS increased from 23.88 ± 0.26 to 24.60 ± 0.23 (p < 0.001). Assessment of lens opacities according to LOCS III classification revealed a decrease in NO from 2.62 ± 0.06 to 2.41 ± 0.06 (p < 0.001) and NC from 2.12 ± 0.06 to 2.02 ± 0.06 (p < 0.001). This indicates a positive trend in the treatment process. Optical biometric data showed a significant decrease in the density of the anterior layers of the lens: from the initial value 9817.5 ± 291.1 to 8781.62 ± 273.95 (p < 0.001). This also confirms an improvement in the condition of the lens. The core density also showed a significant decrease: from 6509.2 ± 151.3 to 5639.97 ± 149.83 (p < 0.001). A similar trend was found for the optical density of the posterior layers of the lens. The results of sonoelastography revealed a significant decrease in the anterior layers and the lens nucleus: from 0.68 ± 0.03 to 0.57 ± 0.02 (p < 0.001) and from 0.38 ± 0.01 to 0.32 ± 0.01 (p < 0.001), respectively. The index of the posterior layers also decreased from 0.51 ± 0.02 to 0.41 ± 0.01 (p < 0.001). The analysis of the acoustic density of the lens showed its significant decrease in the anterior layers, core and posterior layers: from 23.53 ± 0.58 to 21.38 ± 0.54, from 4.93 ± 0.26 to 3.60 ± 0.21 and from 19.97 ± 0.35 to 17.91 ± 0.32 cu, respectively (p < 0.001).

Conclusion. The study demonstrated the effectiveness of azapentacene in the initial age-related changes of the lens, which confirms the validity of its use in clinical practice in order to prevent the early development and progression of cataracts. This approach contributes to the long-term preservation of visual function and, accordingly, to the improvement of patients quality of life.

1. Bikbov M.M., Israfilova G.Z., Gil'manshin T.R., et al . Cataract as a cause of visual impairment: epidemiology and organization of surgical care. Public health and habitat. 2022; 30 (1): 7–13 (In Russ.).

2. Lian R, Afshari N. The quest for homeopathic and nonsurgical cataract treatment. Curr Opin Ophthalmol. 2020; 31: 61–6. https://doi.org/10.1097/ICU.0000000000000631

3. Jingjie X, Qiuli F, Xiangjun Ch. Advances in pharmacotherapy of cataracts. Annals of Translational Medicine. 2020; 8 (22): 1552. https://doi.org/10.21037/atm-20-1960

4. Chen H, Zhou J. Effects of sodium selenite on oxidative damage in the liver. Kidney and Brain in a selenite cataract rat model. Biol Trace Elem Res. 2020; 197: 533–43. https://doi.org/10.1007/s12011-019-02000-1

5. Kiseleva T.N., Zaitsev M.S. Modern concepts of the molecular mechanisms of age-related lens changes. Ophthalmology. 2023; 20 (3): 384–9 (In Russ.). https://doi.org/10.18008/1816-5095-2023-3-384-389

6. Fukushi S, Suzuki T. Studies on azapentacene, anti-cataract agent. Nippon Ganka Gakkai Zasshi. 1981; 85 (1): 37–43.

7. Panchishena V.M., Mukovskii L.A. Antidote efficacy of medicines for eye burns with chloracetophenone. Disaster medicine: experience and development prospects. 2006; 1 (3): 89–90. (In Russ.).

8. Chylack LT Jr, Leske MC, McCarthy D, et al. Lens opacities classification system II (LOCS II). Arch Ophthalmol. 1989; 107 (7): 991–7. doi: 10.1001/archopht.1989.01070020053028

9. Guidance for Industry and FDA staff: information for manufacturers seeking marketing clearance of diagnostic ultrasound systems and transducers. USA: Silver Spring, 2008.

10. Itoh A, Ueno E, Tohno E, et al. Breast disease:clinical application of US elastography for diagnosis. Radiology. 2006; 239: 341–50. https://doi.org/10.1148/radiol.2391041676

11. Stankiewicz A, Poppe E, Stasiewicz B, et al. Ocena skuteczno ci Quinaxu w zapobieganiu rozwojowi za my starczej [Evaluation of the effectiveness of Quinax in the prevention of the development of senile cataract]. Klin Oczna. 1990; 92 (3–4): 52–4 (In Pol.).

12. Egorova E.V. Ultrasound therapy and instillation of anti-cataract drugs in the complex treatment of patients with agerelated cataracts. Bulletin of Samara State University. 2006; 6 (2): 233–9 (In Russ.).

13. Polunin G.S. The effectiveness of drug treatment of various types of cataracts. Consilium Medicum. 2001; 12 (1): 9–11 (In Russ.).