National Journal glaucoma / Национальный журнал глаукома
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Глаукома: что необходимо знать каждому пациенту. Часть 3. Как правильно лечить глаукому? Капли, операции, лазер
Get PDFСравнительный анализ эффективности различных методов нейропротекторной терапии больных первичной стабилизированной глаукомой в далекозашедшей стадии
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Прогнозирование продолжительности сроков заболевания и возраста пациентов с разными стадиями первичной открытоугольной глаукомы
Get PDFPURPOSE: To find out the expected duration of the disease and age of patients with different primary open-angle glaucoma changes. METHODS: The study protocol included data from 120 patients (50 males (41.7%), 70 females (58.3%)); 189 eyes; 102 right eyes; 87 left eyes). The first study group (28 patients, 44 eyes) comprised patients with suspected glaucoma. The second group (53 patients, 84 eyes) consisted of patients with early glaucoma changes. The third group (21 patients, 33 eyes) included patients with advanced glaucoma changes. The forth group (18 patients, 28 eyes) comprised patients with terminal glaucoma. The mean age of the patients was 61.6 (58.4; 66.9) years at the time of diagnosis and 66.9 (63.4; 72.8) years at the endpoint visit in 2013. In all cases the diagnosis was made according to the differential diagnosis system and was proved by special diagnostic techniques. The database included data from 3 qualified examinations as well as tonometry and static automatic perimetry results. RESULTS: The expected mean age of the patients at the moment of total vision loss was 75.1 years. The period, during which patients developed blindness, was limited to 6.1 years. Mean age of the patients at the time of possible glaucoma development was 59.58 (56.14; 64.36) years. The disease itself could have developed within -3.24 (-5.38; -1.2) years prior to the diagnosis. CONCLUSION: Glaucoma diagnostic research should be focused on the age group of 55-60 years. The degree of IOP-lowering in patients with advanced glaucoma changes does not correspond with the Russian glaucoma society recommendations, which determines further progression of the disease
Методы тонометрии и роль различных проб в ранней диагностике глаукомы (часть 1)
Get PDFThis literature review depicts various tonometry methods (Maklakov, elastotonometry, Goldmann tonometry, tonometry by means of Ocular Response Analyzer (ORA) and ICare). The efficacy and accuracy characteristics of different intraocular pressure measuring methods are presented. The article sums up current research on the interdependence of the intraocular pressure and central cornea thickness, the influence of visco-elastic characteristics of the fibrous membrane of the eye on results of some tonometry methods, the correlation of biomechanical indices and interrelation of corneal hysteresis, corneal resistance factor and intraocular pressure. The review describes various stress tests (mydriatic test, Wurgaft compression tonometry test, Heims position test, Krasnov orthoclinostatic test, corticosteroid provocative testing by B. Becker, W. Mills etc.) and stress-relief tests (pilocarpine and epinephrine tests, determining individual tolerant intraocular pressure) used in early diagnostics of glaucoma and the history of their development and practical application
Эффективность Ксалатамакса в лечении начальной стадии первичной открытоугольной глаукомы
Get PDFPURPOSE: To evaluate the efficacy of latanoprost 0.005% treatment for patients with primary open-angle glaucoma during follow-up from the positions of individual IOP level achievement, eye hemodynamics improvement and visual functions stabilization. METHODS: The study included 186 patients with an initial stage of primary open-angle glaucoma (186 eyes) with pseudoexfoliative syndrome. The average age of the patients was 60.4±0.6 years. RESULTS: Individual IOP level was achieved in 119 patients with initial stage primary open-angle glaucoma (119 eyes) - 64% of cases. After latanoprost 0.005% instillation the average IOP value in patients with glaucoma decreased from 22.4±0.7 mm Hg to 15.1±0.7 mm Hg, totaling a decrease of 7.3 mmHg (32.6%) from baseline IOP and fitting into the tolerable IOP green zone (t=7.4; p=0.001). In 67 patients with glaucoma (67 eyes) required a combined drug treatment to reach a needed IOP level. Ophtalmosphygmography showed a significant improvement of hemodynamic parameters of the eyes after intraocular pressure reduction to tolerable IOP level (p=0.001). CONCLUSION: Ophthalmosphygmography parameters (intraocular vessels elasticity index, eye blood supply adequacy index) can be used as hemodynamic criteria in evaluating the effectiveness of primary open-angle glaucoma patients treatment. Glaucoma process stabilization was observed in 95.8% of patients with initial stage of primary open-angle glaucoma after IOP reduction to the individual tolerance level due to latanoprost 0.005% instillation
Роль цитокинов в патогенезе глазных болезней
Get PDFCytokines are a group of regulatory protein mediators. They perform a key role in the development and regulation of inflammatory response, reparative and plastic processes. Cytokines are an important part of humoral immunity and can be synthesized by a variety of cells. On the organism level cytokines create a complex selfregulating system, collectively referred to as the cytokine network. This review provides a brief history of cytokines development, from the first experiments of Coley W. to the introduction of modern classification. The review describes cytokine families that are most frequently studied in the ophthalmologic researches; studies of local and system cytokine profile changes in patients with eye diseases are summed up. Reviewed clinical and laboratory studies relate the influence of different cytokine groups on the inflammation process in patients with various forms of uveitis, effect of cytokines on the development of glaucomatous optic neuropathy and cytokines’ role in other ophthalmic diseases. These researches allow a better understanding of the mechanism of ocular immune privilege and study of ocular diseases pathogenesis on the molecular level. Cytokine research also helped discover the chronic inflammatory component of primary open-angle glaucoma and keratoconus, explain different kinds of inflammatory response in secondary uveitis, and discover new prognostic methods. This new data enables the development of new methods of pathogenetically oriented eye diseases therapy
Изучение структурных особенностей соединительной ткани век у пациентов с первичной открытоугольной глаукомой
Get PDFНовые технологии в диагностике первичной открытоугольной глаукомы
Get PDFPURPOSE: To determine the most important diagnostic criteria to distinguish the preperimetric glaucoma from the perimetric stage using complex analysis of structural, functional and ocular blood flow parameters. METHODS: 90 eyes, including 30 eyes with preperimetric glaucoma, 30 eyes with perimetric glaucoma and 30 normal eyes, were analyzed. The average thickness of the GCC, retinal nerve fiber layer thickness (avg. RNFLT) and choroidal thickness were measured using RTVue spectral-domain optical coherence tomography (SD-OCT). Perimetry - using Humphrey test («Carl Zeiss Meditec», Dublin, CA). Ocular blood flow velocity was measured by the color Doppler mapping («VOLUSON 730 ProSystem»). Intraocular pressure (lOPcc) and corneal hysteresis (CH) were determined using «Ocular Response Analyzer» (ORA). Standardized statistics (Z-value) of Wilcoxon - MannWhitney rank sum test and the area (S-ROC) under the receiver operating characteristic curve for logistic regression model was used to determine the most important diagnostic criteria in glaucoma. RESULTS: The difference between perimetric and preperimetric glaucoma could be characterized by 5 important diagnostic criteria: avg. RNFLT (S-ROC 0.93; z-value 5.75), PSD (0.91; -5.52), peripapillar choroidal thickness (0.7; 2.69), the end diastolic blood flow velocity in the medial posterior ciliary arteries (0.7; 2.55) and corneal hysteresis (0.68; 2.41). CONCLUSIONS: Five clinical parameters have been determined as the most important to distinguish the preperimetric glaucoma from the perimetric stage: avg. RNFLT, PSD, peripapillar choroidal thickness, the end diastolic blood flow velocity in the medial posterior ciliary arteries and corneal hysteresis. This data should be considered in glaucoma monitoring
