scholarly journals The changes of functional, structural and hemodynamic parameters of the optic disc in patients with primary open-angle glaucoma and diabetes mellitus in long-term follow-up

2021 ◽  
Vol 14 (3) ◽  
pp. 54-64
Author(s):  
A. Zh. Fursova ◽  
Ju. A. Gamza ◽  
O. G. Gusarevich ◽  
A. S. Derbeneva ◽  
M. A. Vasil’eva
Keyword(s):  
Optic Nerve ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage I ◽  
Stage Iii ◽  
Vascular Density ◽  
Hemodynamic Parameters ◽  
Open Angle ◽  
Control Groups

Purpose: to study the long-term changes of functional, structural, and hemodynamic parameters of the optic nerve in primary open-angle glaucoma (POAG) accompanied by diabetes mellitus (DM).Material and methods. The study involved 258 patients (258 eyes), which were divided into five groups: 1st group — 58 patients with stage I POAG and DM; 2nd group — 50 patients (50 eyes) with stage I POAG; 3rd — 50 patients with stage III POAG and DM; 4th — 50 patients with stage III POAG; 5th — 50 patients with DM. In addition to a complete ophthalmological examination, the patients underwent spectral optical coherence tomography (OCT), OCT angiography of the optic nerve head and macula. The observation period was 24 months.Results. The worst decrease in maximally corrected visual acuity was noted in patients with DM + POAG (groups 1 and 3): in 1 year of observation — stage I — 10.29%, stage III — 7.32 %, in control groups with isolated POAG stages I and III, 1.15 and 2.04%, respectively, in patients with DM, 1.39%; in 2nd year — 14.71 and 14.63% with a comorbid course of the disease and 1.15 and 4.08% in the absence of DM, respectively. The MD index in the group DM + POAG stage I after 12 months was significantly lower compared to patients with stage I POAG (by 5.05%), after 24 months by 12.12, 0.34 and 1.69%, respectively (p £ 0.05). The groups of comorbid patients showed lower average thickness levels of the retinal nerve fibers layer than in the control groups: 78.81 ± 11.39 μm at stage I and 63.08 ± 10.32 μm at stage III. A similar pattern was noted for the thickness of the neuroretinal rim and its areas as well indicators of the optic disc excavation (volume and c/d ratio).No significant difference was noted in the density of the optic nerve disc perfusion in stages I and III POAG with DM against the respective control groups during the first visit, but we noted a significantly lower vascular density in patients with the initial stage of POAG and DM (0.39 ± 0.04 / mm) than in patients with isolated glaucoma (0.42 ± 0.03 / mm). As the disease progressed, there was a further significant decrease in the average indicators of optic nerve disc perfusion and vascular density (group 3: 39.17 ± 3.43% and 0.33 ± 0.03 / mm).Conclusion. The study of the changes of visual, functional, structural and hemodynamic parameters of the optic nerve showed a faster rate of progression of glaucomatous optic neuropathy if accompanied with DM.

scholarly journals Analysis of changes in structural and hemodynamic parameters of the retina and foveolar avascular zone in patients with primary open-angle glaucoma and diabetes mellitus observed in long-term follow-up

2021 ◽  
Vol 20 (3) ◽  
pp. 59-77
Author(s):  
A. Zh. Fursova ◽  
Y. A. Gamza ◽  
O. G. Gusarevich ◽  
A. S. Derbeneva ◽  
M. V. Vasilyeva ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage I ◽  
Hemodynamic Parameters ◽  
Open Angle ◽  
Avascular Zone ◽  
Long Term Follow Up ◽  
Group 3

PURPOSE. To study the changes in structural and hemodynamic parameters of the retina and foveolar avascular zone (FAZ) over time in patients with primary open-angle glaucoma (POAG) and diabetes mellitus (DM) observed in long-term follow-up.MATERIALS AND METHODS. The study included 258 patients (258 eyes) divided into five groups: group 1 — 58 patients (58 eyes) with stage I POAG and DM; group 2 — 50 patients (50 eyes) with stage I POAG; group 3 — 50 patients (50 eyes) with stage III POAG and DM; group 4 — 50 patients (50 eyes) with stage III POAG; group 5 — 50 patients (50 eyes) with DM. Patients underwent comprehensive ophthalmological examination, spectral domain optical coherence tomography (SD-OCT), optical coherence tomo-graphy angiography (OCT-A) of the macular region. The follow-up lasted 24 months.RESULTS. Analysis of the initial parameters in groups of patients with comorbidities showed the lowest values compared to controls, which were progressively worsening. MD in the group with DM + stage I POAG had reliably decreased after 12 months (by 5.05%), after 24 months by 12.12% (p≤0.05). The speed of GCL+IPL loss in groups 1 and 3 during the first year of observation was almost equal for initial and advanced glaucoma — 1.35 (-2.03%) and 1.32 (-2.36%) µm/year, but in group 3 the loss had doubled after two years (2.48 (-4.44%) and 1.41 (2.12%) µm/year). Deterioration of hymodynamic parameters in the macular region in groups 1 and 3 was noted primarily in the inner sectors (whole image vessel density in parafovea (PF wiVD) -0.79% during the first, and -2.57% during the second year in initial glaucoma, -0.6% and -1.24% in advanced, whole image vessel density in parafovea (PF wiVD) -0.2% and -1.22%, -0.66% and -1.56%, respectively). Parameters of FAZ had changed significantly after 2 years in patients with stage I POAG and DM: its area size had increased by 10.2%, perimeter by 4.49%, circularity index had decreased by 3.17%.CONCLUSION. Comorbidity of POAG and DM is accompanied by development and quick progression of significant changes in structural and hemodynamic parameters of the retina as observed by this long-term follow-up.

scholarly journals Comparison of the Clinical Efficacy of Draining Autovalve Limbosclerectomy and Trabeculectomy in the Treatment of Primary Open-Angle Glaucoma with Long-Term Follow-Up

2020 ◽  
Vol 17 (1) ◽  
pp. 49-55
Author(s):  
D. V. Lapochkin ◽  
V. I. Lapochkin ◽  
A. V. Lapochkin
Keyword(s):  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage Iv ◽  
Stage I ◽  
Control Group ◽  
Open Angle ◽  
Disposable Instruments

Purpose: to evaluate the immediate and long-term hypotensive efficacy, the number of complications, and the clinical benefits of a draining autovalve limbosclerectomy (DALS) performed using a kit of disposable instruments in patients with POAG of various stages in comparison with trabeculectomy (TE).Patients and Methods. The study is based on the analysis of the clinical and functional condition of 127 eyes of 127 patients with primary open-angle glaucoma (stage I POAG was detected in 2 eyes, stage II in 30 eyes, stage III in 88 eyes and stage IV in 7 eyes). Patients were divided into groups: the main group—76 people who underwent DALS using a set of disposable instruments, and the control group—51 people who underwent TE. The average age of patients is 68.9 ± 10.3 years. Before and within 24 months after surgery, all patients underwent standard diagnostic examinations. The initial level of IOP against the background of the maximum antihypertensive mode varied from 24 to 50 mm. Hg. According to gonioscopy, the angle of the anterior chamber was open in all cases (III–IV degree). Patient exclusion criteria: history of laser or surgical treatment of glaucoma, cataract treatment.Results. After 24 months of follow-up after DALS, the level of IOP in patients with stage I–II of POAG was 14.19 ± 1.83 mm Hg and with III–IV stage of POAG 14.95 ± 2.15 mm Hg, compensation was achieved in 88.2 % of patients without the use of antihypertensive drops. After TE, compensation was received in 72.6 % of patients, the IOP level was 16.9 ± 2.21 and 17.78 ± 2.31 mm Hg. respectively (p < 0.01). After DALS surgery, a decrease in the number of complications was revealed in comparison with TE: a decrease in сiliochoroidal detachment by 9.1 %, hyphema by 2.5 %, ophthalmic hypertension in the early p/o period by 3.2 %, cystic changes in the filtering bleb by 7.1 %.Conclusion. The standardized DALS operation using a disposable tool kit is a new highly effective and safe method for the surgical treatment of glaucoma. DALS may be the operation of choice in the treatment of POAG of all stages.

Problems of treatment of primary openangle glaucoma in combination with thrombosis of the central retinal vein

GlaucomaNews ◽  
2020 ◽  
pp. 65-69
Author(s):  
T.E. Lipatkina ◽  
◽  
Е.V. Karlova ◽  
A.V. Zolotarev ◽  
◽  
...  
Keyword(s):  
Macular Edema ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Vascular Wall ◽  
Open Angle ◽  
Retinal Edema ◽  
Long Term Preservation ◽  
Central Retinal Vein

Patients with primary open-angle glaucoma (POAG) and ophthalmic hypertension have an increased likelihood of developing occlusions (thrombosis) of the central retinal vein. Different groups of antihypertensive drugs differ in their mechanism of action and may affect concomitant ocular pathology, in particular, retinal edema, which occurs, for example, in occlusion of the central retinal vein. Used in most patients with glaucoma, prostaglandin analogs can contribute to the long-term preservation of macular edema due to the effect on the permeability of the vascular wall. Preparations of other pharmacological groups, reducing the production of aqueous humor, on the contrary, may contribute to its regression. Therefore, the question of choosing a drug for antihypertensive therapy in patients with primary open-angle glaucoma and concomitant macular edema is relevant and is for further study.

scholarly journals The Effects of Trabeculectomy on Pseudoexfoliation Glaucoma and Primary Open-Angle Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fan Li ◽  
Guangxian Tang ◽  
Hengli Zhang ◽  
Xiaowei Yan ◽  
Lihua Ma ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Success Rates ◽  
Pseudoexfoliation Glaucoma ◽  
Long Term Effects ◽  
Surgical Success

Purpose. To compare long-term effects of trabeculectomy on pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods. This retrospective case-control study included 53 eyes of PXG and 76 eyes of POAG. Intraocular pressure (IOP), number of antiglaucoma medications used, surgical success rate, and occurrence of complications were observed and statistically analyzed in both groups at 3 and 6 months and at 1, 3, and 5 years after trabeculectomy. Surgical success was defined according to the following 3 criteria: (1) IOP ≤ 21 mmHg; (2) IOP ≤ 18 mmHg; (3) IOP ≤ 15 mmHg. Complete success is defined as patients met these criteria without medical treatment, and qualified success is defined as patients met these criteria with medical treatment (≤3 medications). Cumulative probabilities of success were compared using the Kaplan–Meier survival analysis. Results. For the 3 criteria, there were no statistically significant differences in complete and qualified success rates between the two groups at 3 and 6 months after trabeculectomy (P>0.05). For criterion A, complete success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion B, complete and qualified success rates in PXG at 3 and 5 years after surgery were lower than those in POAG; for criterion C, complete and qualified success rates in PXG at 1, 3, and 5 years after surgery were lower than those in POAG, the differences were statistically significant (P<0.05). Conclusions. The short-term success rates of both types of glaucoma were similar; however, the long-term success rate of PXG was significantly lower, and it was difficult to achieve long-term control of IOP at a low target level.

Blood circulation and morphology of optic nerve head in primary open-angle glaucoma

2000 ◽  
Vol 78 (S232) ◽  
pp. 40-40
Author(s):  
M. Ciancaglini ◽  
P. Carpineto ◽  
G. Falconio ◽  
S. Scaramucci ◽  
G. C. Nicola ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Blood Circulation ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle

scholarly journals Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Martina Tomić ◽  
Snježana Kaštelan ◽  
Kata Metež Soldo ◽  
Jasminka Salopek-Rabatić
Keyword(s):  
Intraocular Pressure ◽  
Ocular Surface ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Final Visit ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Prostaglandin Analog ◽  
Ocular Surface Health

Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG.Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%.Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg;P<0.001). Mean TBUT decreased from11.70±1.86seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (P<0.001).Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.

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