Elevated urine formaldehyde in elderly patients with primary open angle glaucoma

У пациентов пожилого возраста часто наблюдается сочетание полиморбидной сердечно-сосудистой патологии с офтальмопатологией и, в частности, с первичной открытоугольной глаукомой (ПОУГ). Однако гериатрический статус таких пациентов изучен недостаточно. Цель исследования: изучение особенностей гериатрического статуса пожилых больных с сочетанной сердечно-сосудистой и офтальмопатологической патологией. Обследовано в клинических условиях 58 пациентов с инфарктом миокарда, артериальной гипертензией и первичной открытоугольной глаукомой. Установлено, что развитие офтальмопатологии в виде первичной открытоугольной глаукомы в сочетании с сердечно-сосудистой патологий сопровождается формированием и прогрессированием гериатрического континуума пожилых пациентов. Уровень личностной тревожности при первичной гериатрической оценке у анализируемых больных составлял 42,9±1,1 балла и соответствовал умеренному уровню тревожности. Однако после хирургического лечения он незначительно понизился до 40,6±1,2 балла (Р±0,05). Аналогичные изменения характерны и для ситуативной тревожности, которая при первичной гериатрической оценке была умеренной (40,8±1,2 балла) и не претерпела существенных изменений после выполнения антиглаукомного хирургического вмешательства, составив 40,3±1,4 балла (Р±0,05). Оценка когнитивного статуса пациентов пожилого возраста с первичной открытоугольной глаукомой в до и после операционном периодах показывает недостоверное снижение когнитивного дефицита. Уровень когнитивных нарушений по шкале CFS у пациентов в предоперационном периоде составлял 18,22±0,4 балла (легкие когнитивные нарушения). Следовательно, полиморбидная патология изменяет гериатрический статус пациентов, что следует учитывать в гериатрической практике In elderly patients, a combination of polymorbid cardiovascular pathology with ophthalmopathology and, in particular, with primary open-angle glaucoma (POAG) is often observed. However, the geriatric status of such patients has not been sufficiently studied. Objective: to study the features of the geriatric status of elderly patients with combined cardiovascular and ophthalmopathological pathology. A total of 58 patients with myocardial infarction, arterial hypertension, and primary open-angle glaucoma were examined in clinical settings. It was established that the development of ophthalmopathology in the form of primary open-angle glaucoma in combination with cardiovascular pathology is accompanied by the formation and progression of the geriatric continuum of elderly patients. The level of personal anxiety in the primary geriatric assessment in the analyzed patients was 42.9±1.1 points and corresponded to a moderate level of anxiety. However, after surgical treatment, it decreased slightly to 40.6±1.2 points (P±0.05). Similar changes are also characteristic of situational anxiety, which was moderate (40.8±1.2 points) in the initial geriatric assessment and did not undergo significant changes after performing anti-glaucoma surgery, amounting to 40.3±1.4 points (P±0.05). Assessment of the cognitive status of elderly patients with primary open-angle glaucoma in the pre-and postoperative periods shows an unreliable decrease in cognitive deficits. The level of cognitive impairment on the CFS scale in patients in the preoperative period was 18.22±0.4 points (mild cognitive impairment). Consequently, polymorbid pathology changes the geriatric status of patients, which should be taken into account in geriatric practice

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SELECTIVE LASER TRABECULOPLASTY IN ELDERLY PATIENTS WITH ADVANCED OPHTHALMOPATHOLOGY

СИСТЕМНЫЙ АНАЛИЗ И УПРАВЛЕНИЕ В БИОМЕДИЦИНСКИХ СИСТЕМАХ ◽

10.36622/vstu.2020.19.3.012 ◽

2020 ◽

pp. 97-103

Author(s):

Лия Шамильевна Рамазанова ◽

Татьяна Игоревна Субботина ◽

Павел Львович Володин ◽

Кристина Феликсовона Макконен ◽

Владимир Александрович Мачехин ◽

...

Keyword(s):

Elderly Patients ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

The Elderly ◽

Open Angle ◽

Selective Laser Trabeculoplasty ◽

Laser Trabeculoplasty ◽

Results Of Treatment ◽

Age Related ◽

Clinical Conditions

В пожилом возрасте сочетание первичной открытоугольной глаукомы с катарактой представляет актуальную медико-социальную проблему и требует новых методов лечения. Цель исследования - анализ результатов лечения у пациентов с далекозашедшей первичной открытоугольной глаукомы и возрастной катарактой методом селективной лазерной трабекулопластики. В клинических условиях проведена селективная лазерная трабекулопластика 24 пациентам пожилого возраста с сочетанной первичной открытоугольной глаукомой и катарактой. При оценке результатов лечения изучались морфометрические и функциональные показатели зрительных функций общепринятыми в офтальмологической практике методами. Установлено, что селективная лазерная трабеклопластика снижает внутриглазное давление и стабилизирует глаукомный процесс. Использованный метод лечения сочетанной первичной открытоугольной глаукомы с катарактой обеспечивает достоверное уменьшение объёма глобальных потерь, увеличение толщины хориоидеи перипапиллярной и фовеальной области, суммы полей зрения. Поэтому данный метод селективной лазерной трабекулопластики следует активно применять у пациентов с первичной открытоугольной глаукомой и катарактой в пожилом возрасте In old age, the combination of primary open-angle glaucoma with cataract is an urgent medical and social problem and requires new methods of treatment. The aim of the study was to analyze the results of treatment in patients with far-advanced primary open-angle glaucoma and age-related cataracts using selective laser trabeculoplasty. In clinical conditions, selective laser trabeculoplasty was performed in 24 elderly patients with combined primary open-angle glaucoma and cataracts. When evaluating the results of treatment, morphometric and functional indicators of visual functions were studied using methods generally accepted in ophthalmological practice. It was found that selective laser trabeculoplasty reduces intraocular pressure and stabilizes the glaucoma process. The used method of treatment of combined primary open-angle glaucoma with cataract provides a significant reduction in the volume of global losses, an increase in the thickness of the choroid of the peripapillary and foveal regions, and the sum of the fields of vision. Therefore, this method of selective laser trabeculoplasty should be actively used in patients with primary open-angle glaucoma and cataracts in the elderly

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Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-97-105 ◽

2020 ◽

pp. 97-105

Author(s):

E. N. Simakova ◽

O. V. Stenkova

Keyword(s):

Intraocular Pressure ◽

Drug Therapy ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Randomized Study ◽

Main Group ◽

Control Group ◽

Open Angle ◽

Complex Treatment ◽

Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

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