Corneal endothelial density: An indicator for primary glaucoma progression

Purpose. To study the role of optical coherence tomography (OCT) and OCT angiography (OCTA) in the detection of the primary glaucoma progression. Material and methods. The prospective study of 128 patients with primary glaucoma (128 eyes), conducted from 2015 to 2019, included at least 6 standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT) examinations in each patient; OCTA was also used during the last year of observation. To determine the disease progression, the trend and event analysis using the Humphrey Field Analyzer was performed. The fact and rate of thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated. If they had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The values of corneal-compensated IOP were also considered: minimal (IOPmin) and peak (IOPmax). Results. Glaucoma progression was detected in 79 eyes. The isolated use of SAP allows detecting the progression only in 2.3% cases, SD-OCT - in 37.5%, among them the isolated assessment of GCC amounted to 7.8%, and RNFL – to 5.5%. The complex dynamic morphological and functional assessment increased the possibility of progression detection up to 61.7%. Progression was related to the stage of glaucoma damage at the moment of diagnosis: for the perimetry index PSD p=0.025, for the focal loss volume of GCC p=0.024, as well as with the level of minimal IOP (p=0.04). All patients with progression have shown the vessel density decrease in the peripapillary retina and parafovea. Conclusion. SD-OCT plays an important role in detecting the progression of glaucoma. The complex dynamic morphological and functional assessment allows detecting the progression in over half of patients. Progression is associated with the initial stage of glaucoma and an insufficient IOP decrease during treatment, accompanied by retinal microcirculation deterioration. Key words: primary, glaucoma progression, optical coherence tomography, OCT-angiography, IOP.

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PECULIARITIES OF RISK FACTORS FOR GLAUCOMA PROGRESSION AND THEIR IMPACT ON DEVELOPMENT OF THE DISEASE

Клінічна та профілактична медицина ◽

10.31612/2616-4868.3(9).2019.05 ◽

2019 ◽

Vol 4 (9-10) ◽

pp. 41-46

Author(s):

O. B. Koshchynets ◽

V. V. Kapechuk ◽

N. U. Krytsun

Keyword(s):

Late Stage ◽

Social Activity ◽

Medical Statistic ◽

Glaucoma Progression ◽

Initial Stage ◽

Literary Sources ◽

District Hospitals ◽

Social Insecurity ◽

Complicated Course ◽

Primary Glaucoma

Objective: To identify factors of glaucoma progression andt heir impact on the development of late-stage glaucoma. Materials and methods. Analysis of literary sources, sociological and medical-statistic. As part of a special program running at three in-patient ophthalmology departments at district hospitals in Ivano-Frankivsk region. A representative group of 515 people with primary glaucoma, including 347 respondents from I-II (initial) stage of primary glaucoma and 168 patients of III-IV (later) stages of the disease have been surveyed. Results and discussion. It was proved that the chances of complicated course of glaucoma increase with age, in males, in patients with burdened heredity and concomitant cardiovascular diseases. Poor education, unemployment, loneliness, poor physical and social activity, harmful habits facilitate vision deterioration in glaucoma patients. Conclusions. It was reported that the development of late-stage glaucoma significantly decreases quality of life by deteriorating health, decreased daily activity, increased anxiety and depression, elevated sense of social insecurity. The chances of late-stage glaucoma development increase with insufficient coverage by ophthalmological screening and low compliance tot reatment. This indicates the potential to prevent complications of glaucoma at the level of primary healthcare.

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The Assessment of Morphological and Functional Changes in the Detection of the Initial Stage of Primary Glaucoma

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-4-857-865 ◽

2021 ◽

Vol 18 (4) ◽

pp. 857-865

Author(s):

N. I. Kurysheva ◽

L. V. Lepeshkina

Keyword(s):

Open Angle Glaucoma ◽

Angle Closure ◽

Ganglion Cell Complex ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Fiber Layer ◽

Glaucoma Progression ◽

Functional Changes ◽

Primary Glaucoma ◽

Sd Oct

Purpose — to study morphological and functional changes in the detection of primary glaucoma progression.Patients and methods. 128 patients (128 eyes, among them — 64 eyes with primary open angle glaucoma (POAG) and 64 with primary angle closure glaucoma (PACG)) with the initial MD of –6.0 dB were examined at the Ophthalmology Center of the FMBA of Russia from May 2016 to November 2019. The values of corneal-compensated IOP were also considered: minimal (IOPmin), peak (IOPmax) and its fluctuations (IOPfluct). The progression was measured using standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). During the observation period, each patient received the average of 8.42 ± 2.08 SAP and SD-OCT. Progressive thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated using SD-OCT. If RNFL and/or GCC had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The correlation between the rate of progression detected by SAP (ROP1) using thinning of RNFL (ROP2) and GCC (ROP3) with other clinical parameters was analyzed.Results and discussion. Glaucoma progression was detected in 73 eyes. While the isolated use of SAP did not allow detecting progression, it was possible to detect it in 39 % cases by SD-OCT. The combination of both methods allowed detecting progression in 57 %. In both forms, ROP1 correlated with IOPmin: in PACG r = 0.41, p = 0.023 and in POAG r = 0.43, p = 0.016. In PACG, ROP2 and ROP3 correlated with the foveal choroid thickness: r = 0.46, p = 0.019 and r = 0.47, p = 0.009, respectively. At the same time, ROP3 was associated with peak IOP (r = –0.402, p = 0.025); the correlation of peak IOP with its fluctuations amounted to 0.7 (p < 0.001).Conclusion. SD-OCT is more informative than SAP in determining the progression of the initial primary glaucoma. The combination of these two methods 1.5 times increases the possibility of detecting progression in comparison with the isolated use of SD-OCT. The choroid thickness, associated with the IOP fluctuations, plays an important role in the progression of PACG.

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Primary glaucoma etiology: current theories and researches

Ophthalmology journal ◽

10.17816/ov2015247-56 ◽

2015 ◽

Vol 8 (2) ◽

pp. 47-56 ◽

Cited By ~ 3

Author(s):

Sergey Yuryevich Petrov ◽

Nnatal'ya Dmitrievna Fokina ◽

Lyudmila Vladimirovna Sherstneva ◽

Sergey Viktorovich Vostruhin ◽

Dar'ya Maksimovna Safonova

Keyword(s):

Cell Death ◽

Programmed Cell Death ◽

Optic Neuropathy ◽

Trabecular Meshwork ◽

Genetic Basis ◽

Glaucoma Progression ◽

Immunological Mechanisms ◽

Primary Glaucoma

The article presents a review of latest researches related to various aspects of primary glaucoma and optic neuropathy etiology. The effect of somatic factors on glaucoma progression is described. Arguments in favor of the interrelation of glaucoma and neurodegenerative processes are presented. The genetic basis for the development of glaucoma and a variety of its conjoined syndromes is considered. Immunological mechanisms that initiate the programmed cell death are analyzed. The processes that influence the increase of trabecular meshwork retention are also described as well as its role in the glaucoma pathogenesis.

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