scholarly journals RISK FACTORS FOR THE OCCURRENCE OF PRIMARY OPEN-ANGLE GLAUCOMA IN PATIENTS WITH DIABETIC RETINOPATHY AND TYPE 2 DIABETES

2021 ◽  
Vol 77 (3) ◽  
pp. 37-46
Author(s):  
K. A. Gudzenko ◽  
S. Yu. Mogilevskyy ◽  
М. L. Kyryliuk ◽  
D. S. Ziablitsev
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Duration Of Diabetes

The aim of this work was to identify risk factors for the occurrence of primary open-angle glaucoma in patients with diabetic retinopathy and type 2 diabetes mellitus by conducting a regression analysis of the mutual influence of these diseases. We examined 649 patients (649 eyes), among whom 301 patients (301 eyes) had diabetic retinopathy and glaucoma; 164 patients (164 eyes) had diabetic retinopathy only; 81 patients (81 eyes) had only glaucoma and 103 patients (103 eyes) did not have these diseases (control). The construction of logistic regression models was carried out in the GLZ module of the Statistica 10 software (StatSoft, Inc. USA). It was found that the development of primary open-angle glaucoma directly depended on the duration of diabetes and the intraocular pressure level, and vice versa — on visual acuity (p < 0.001). The development of diabetic retinopathy did not depend on the presence of glaucoma, but it was directly dependent on the blood content of glucose and glycated hemoglobin. Men had a lower risk of developing diabetic retinopathy than women(OR = 0.800; 95% CI 0.76-0.84). Also, men had a lower risk of glaucoma (OR = 0.95; 95% CI 0.94–0.96). Stratification by stages of diabetic retinopathy showed the effect of intraocular pressure, decreased visual acuity and glaucoma stages on the development of proliferative diabetic retinopathy (p < 0.001). Increased intraocular pressure was an independent factor in the development of retinopathy. The development of glaucoma of the initial stage was directly influenced by an increase of blood glycated hemoglobin and by the stage of diabetic retinopathy. The occurrence of stage 2 glaucoma was influenced by the duration of diabetes and visual acuity, stage 3 glaucoma — by visual acuity, and stage 4 glaucoma – by the age and duration of diabetes. Independent risk factors for glaucoma were duration of diabetes, increased intraocular pressure, and low visual acuity. When stratified by stage, there was no evidence of a reduction in the risk of developing diabetic retinopathy and glaucoma in men. Thus, the features of the mutual influence of the development of diabetic retinopathy and primary open-angle glaucoma in type 2 diabetes mellitus have been established.

Features of Diabetic Retinopathy Combined with Type 2 Diabetes Mellitus and Primary Open-Angle Glaucoma

2021 ◽  
pp. 85-96
Author(s):  
K. A. Gudzenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Disease Rate ◽  
Open Angle ◽  
Statistical Research

Relevance. Common mechanisms of pathogenesis of diabetic retinopathy (DR) with type 2 diabetes mellitus (DM2) and glaucoma optic neuropathy (GON) with primary open-angle glaucoma (POAG) involve the possibility of their mutual clinical burden. The aim. To explore the features of the combination of DR in DM2 and POAG in terms of progression of the stages of the pathological process. Material and methods. 546 patients were examined (546 eyes): 301 patients (301 eyes) had DM2 and POAG; 164 patients (164 eyes) had DM2 and DR, but did not have POAG; 81 patients (81 eyes) had POAG, but did not have DM2. The DR stage was established according to the American Academy of Ophthalmology classification (2002); POAG stage was determined according to the classification of perimetric changes. Some patients were diagnosed with normal tension glaucoma (NTG; 72 eyes). The DR and GON progression indices in patients with POAG were calculated on the basis of the stage and the duration of the diseases and the patients’ age. The software used for statistical research: MedStat і MedCalc v.15.1 (MedCalc Software bvba). Results. The DR progression (by the ratio of the DR stage to the duration of the DM2) at various combinations with POAG had no significant differences. It increased only when NTG was combined with DM2. GON progression was higher when POAG was combined with DM2. In case of DM2 combined with POAG, the progression of GON was as follows. In the case of its primary development, it was higher in NTG, and when it was connected to DM2 – in POAG. The disease index (the ratio of the primary disease rate to age) was the highest when DM2 was combined with POAG, which made the progression of GON 1.2 times faster (p=0.001). The duration of comorbidity in the POAG + DM2 group was 3-4 years more than in DM2 + POAG and NTG + DM2 groups (p<0.001). No gender differences in the DR and GON progression were found. Conclusions. The studied characteristic of the combination of DR with DM2 and POAG revealed complex and ambiguous mechanism of their possible interaction, which dictates the need for further investigation of the mechanisms of their comorbidity. Keywords: diabetic retinopathy, type 2 diabetes mellitus, primary open-angle glaucoma, comorbidity.

scholarly journals Prevalence and characteristics of primary open-angle glaucoma in patients with diabetic retinopathy in type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. 14-20
Author(s):  
S.Yu. Mogilevskyy ◽  
K.A. Hudzenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage I ◽  
Open Angle

Background. Numerous literature data made it possible to establish the dependence of primary open-angle glaucoma (POAG) in patients with diabetic retinopathy (DR) on type 2 diabetes mellitus (DM2). The purpose was to determine the prevalence and characteristics of primary open-angle glaucoma in patients with diabetic retinopathy in type 2 diabetes mellitus. Material and me­thods. One thousand four hundred and fifty patients with DM2 were examined, in whom the stage of DR was determined according to the classification of American Academy of Ophthalmology (2002). POAG stage was established according to the classification of A.P. Nesterov and A.Ya. Bunin (1976) and classification of perimetric changes by glaucoma stages. The age of patients, 970 (66.9 %) men and 480 (33.1 %) women, was from 45 to 75 years. The duration of DM2 was from 2 to 15 years. For statistical studies, MedStat and MedCalc v.15.1 (Medcalc Software bvba) were used. Results. In patients with DM2 and DR of different stages, the prevalence of POAG amounted to 20.8 %, which is 4–6 times higher than in the general population. Among individuals with DR stage I (no retinopathy), 71.6 % had POAG stage I and II, among patients with non-proliferative DR, 87.6 % had stages II and III, and among those with proliferative DR, 78.4 % had stages III and IV. Among all patients with DR and POAG, the proportion of normal tension glaucoma was 18.6 %, which did not differ from that in POAG without DM2. 42.9 % of patients initially had the development of DM2 in past medical history, joined by POAG in 1–7 years, and 57.1 % first had POAG, joined by DM2 in 1–8 years. Depending on the duration of the disease, the severity of both DR and POAG increased, which indicated the dependence of DR and POAG severity on disease duration and acceleration of their development if they combined. Conclusions. The results of the study confirmed the wider pre­valence and mutual burden of DR course in DM2 and POAG, which justifies the need to study the general mechanisms of their pathogenesis.

scholarly journals Evaluation of Outflow StructuresIn Vivoafter the Phacocanaloplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Daiva Paulaviciute-Baikstiene ◽  
Renata Vaiciuliene ◽  
Vytautas Jasinskas ◽  
Ingrida Januleviciene
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Open Angle ◽  
Glaucoma Medication ◽  
Postoperative Visual Acuity

Purpose. To evaluate thein vivochanges in Schlemm’s canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT).Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery.Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) (p<0.05) mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2versus 5098.8 (1190.5) μm2,p<0.001) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm,p=0.001) after surgery. We found negative correlations between SC area and IOP before surgery (r=-0.67,p=0.03) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (r=-0.80,p=0.005).Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease.

scholarly journals Ozone Therapy as treatment for severe cases without good evolution in ophthalmology [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Karla Tratsk
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Age Related Macular Degeneration ◽  
Open Angle ◽  
Ozone Therapy ◽  
Age Related ◽  
Insulin Dependent ◽  
Retinal Artery

PURPOSE: In ophthalmology many diseases lead to irreversible blindness, something that implies millions of dollars in care because people with these difficulties loose their autonomy, becoming dependent in all their everyday activities. This presentation will focus on clinical cases of the following pathologies treated with Ozone Therapy because all these were already being treated in a conventional way without signs of improvement. They are primary open-angle glaucoma, age-related macular degeneration, diabetic retinopathy, occlusion of the central retinal artery, facial paralysis and herpetic polyneuropathy associated with orbital apex syndrome. CASE PRESENTATION: As an example, a patient, 73 , female, insulin-dependent diabetes for 10 years, with primary open angle glaucoma, diabetic retinopathy with various laser photocoagulations, vitrectomies and intravitreal injections in both eyes (BE). Visual acuity (VA) of 20/200 in right eye (RE) and 20/100 in left eye (LE). Subjected to the facectomy in RE and with cataract in LE. The fundoscopy was stable in BE. The VA went to 20/200 on 1st day of postoperative period and remained stable until 21st day. After integrative treatment with Ozone Therapy the patient got a VA of 20/60-2 in RE and 20/40-2 in LE, restoring vision and improving her quality of life. Furthermore, she stopped to be insulin dependent, only having to take oral medication. CONCLUSION: The result shows that Ozone therapy should be a therapeutic tool to be associated with Ophthalmology because in many cases, including difficult treatment and evolution, it recovers visual acuity and re-establishes ocular physiology, promoting the maintenance of eye health and vision, contributing to the preservation of autonomy in the lives of patients.

scholarly journals Outcome of Conventional Trabeculectomy in Terms of Intraocular Pressure and Visual Acuity in Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Tertiary Care Hospital ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Open Angle ◽  
Retrobulbar Anaesthesia

Purpose:  To determine the outcomes of conventional trabeculectomy in terms of decrease in Intra Ocular Pressure (IOP) and improvement in visual acuity in patients of primary open glaucoma, coming to a tertiary care hospital. Study Design:  Retrospective case series. Place and Duration of Study:  Ophthalmology department of a tertiary care hospital from January 2017 to December 2018. Methods:  Patients undergoing trabeculectomy for Primary open angle glaucoma were included. Patients with repeated trabeculectomy, failed argon laser trabeculoplasty, advance cataract, corneal opacities and absolute glaucoma were excluded. All the trabeculectomies were done under retrobulbar anaesthesia after taking all aseptic measures. Primary outcome measures were preoperative and postoperative visual acuity, intraocular pressure, number of antiglaucoma medications and failed or successful trabeculectomy. Results:  Total 52 patients underwent trabeculectomy. There were 36 (69.2%) males and 16 (30.8%) females. Mean age was 56.73 years ± 10.9 SD. Mean preoperative IOP was 30.96 ± 6.71 mm Hg, post operatively IOP at 1 year it was 15.6 ± 4.2 mm Hg. P value was <.000. Mean number of antiglaucoma medications was 3.03 and 1.19, pre and post-operatively respectively (p value <.000). Improvement in visual acuity after trabeculectomy was seen in 32 (61.5%) patients. Complete Surgical success was seen in 28 (53.8%) and qualified success in 21 (40.4%) patients. Failed trabeculectomy was seen in 3 (5.8%) patients. Conclusion:  Conventional trabeculectomy is effective in lowering IOP in primary open angle glaucoma patients. It maintains IOP within normal range with and without anti-glaucoma medications at 1 year follow-up. Trabeculectomy significantly reduces number of anti-glaucoma medications. Key Words:  Intraocular pressure, Primary open angle glaucoma, Trabeculectomy.

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