Saratov JOURNAL of Medical and Scientific Research

primary open-angle glaucoma

Comorbidity of diseases of the cardiovascular system and primary open-angle glaucoma

Year: 2018, volume 14 Issue: №4 Pages: 949-953
Heading: Ophtalmology Article type: Review
Authors: Zagidullina A.Sh., Latypova Е.А., Nugmanova A.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

This literature review examines the potential diagnostic contribution of syndromes and cardiovascular diseases: hypertension, atherosclerosis, vascular dystonia, and cerebrovascular pathology in the development of primary open-angle glaucoma (POAG). The study of relationships is relevant due to the commonality of some pathogenetic factors of POAG and these diseases and syndromes. It is necessary to take into account the effect of comorbid pathology in the early diagnosis of POAG, which will improve its quality, and the correction of associated disorders will contribute to the effectiveness of complex treatment of the disease.

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Modifications of trabeculectomy in glaucoma treatment

Year: 2018, volume 14 Issue: №4 Pages: 831-833
Heading: Ophtalmology Article type: Original article
Authors: Kiseleva О.А., Bessmertny A.M., Suleiman Е.А., Lugovkina K.V.
Organization: Moscow Helmholtz Research Institute of Eye Diseases
Summary:

Purpose: to study efficacy of new trabeculectomy modifications for surgical treatment of primary open- angle glaucoma (POAG). Material and Methods. 49 patients with POAG (49 eyes) aged 51-73 years underwent modified surgery. The main technique of first new modification includes preparation of scleral flap, excision of trabecular tissue along the scleral spur, torsion of scleral flap for 180° and reposition of scleral flap in its original bed secured with interrupted nylon sutures (group 1). The main technique of second new modification includes preparation of scleral flap, excision of trabecular tissue, sewing of scleral flap in the middle with resorbable thread and tightening it into folds. Reposition and fixation of scleral flap and conjunctival flap closure completes the operation (group 2). The efficacy of new modifications of trabeculectomy was assessed during 12 months using complete ocular examination, optical coherence tomography of the anterior segment of the eye (ASOCT) in the early postoperative period and ultrasound biomicroscopy (UBM) subsequently. Results. One month after the surgery average intraocular pressure (ave. IOP) was 10.1±1,9 mmHg in group 1 and 11.2± 1.8 mmHg in group 2 (M±a). At 6 months this parameter was 12.6±3.0 mmHg (group 1) and 13,3±2,7 mmHg (group 2). At 12 months ave. IOP was 15.9±4.1 mmHg (group 1)and 17.3±2.7 mmHg (group 2). Conclusions. The newly developed modifications of trabeculectomy allow to obtain a prolonged hypotensive effect after surgical treatment of POAG.

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Main markers of vascular endothelium dysfunction in primary open-angle glaucoma

Year: 2018, volume 14 Issue: №4 Pages: 820-824
Heading: Ophtalmology Article type: Review
Authors: Nugmanova A.R., Zagidullina A.Sh.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

The review presents current literature data on the functions of the vascular endothelium, its role in the pathogen-esis of vascular pathologies, as well as the main markers of its dysfunction. Vascular endothelium plays a role in the development of thrombosis, angiogenesis, remodeling of the vascular wall. It is involved in the regulation of vascular tone, local hemostasis, proliferation. The results of clinical studies of the endothelium capacity, which disorders may accompany primary open-angle glaucoma and contribute to the progression of glaucomatous optic neuropathy, are presented here.

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Assessment of possibilities of transmission polarization mapping for the characterization of sclera macrostructure

Year: 2017, volume 13 Issue: №2 Pages: 435-441
Heading: Ophtalmology Article type: Original article
Authors: Shvachkina M.E., Pravdin А.В., Tikhonov D.A., Kamenskikh T.G., Yakovlev D.D., Yakovlev D.A.
Organization: Saratov state university, Saratov State Medical University
Summary:

The purpose of the study is to assess possibilities of applying the method of transmission polarization mapping for characterization of sclera structure. Material and methods. In the work, samples of rat, rabbit, porcine, and human sclera were examined. Samples of the human sclera were taken (enucleation of the eyeball) from patients with diagnoses: terminal painful glaucoma, subatrophy of the eyeball. From the enucleated eyes, sclera samples were taken from the posterior pole of the eye and from the equator. The sample transparency required for carrying out transmission polarization mapping in thick samples was achieved using immersion optical clearing, 85% and 50% aqueous glycerol solutions and 40% aqueous glucose solution being used as immersion agents. The polarization mapping system used in this work was assembled on the basis of a polarization microscope equipped with a measuring video camera. Re-sults. It is shown that the method of transmission polarization mapping can be used to measure the parameters of the orientational order of scleral collagen fibers, mapping of human sclera samples requiring conduction of the polarization measurements under optical clearing conditions. Since the disorganization of collagen structures of eye connective tissue can be considered as the initial stage of glaucoma process, the technique of transmission polarization mapping can be used as a basis for in vitro studies of the pathogenesis of primary open-angle glaucoma. Conclusion. The potential and limitations of polarization mapping in studying sclera structure in vitro have been established.

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Evaluation of the effectiveness of antiglaucomic operations with the use of the Ex-Press mini glaucoma shunt and Repegel-1 drainage in patients wi

Year: 2017, volume 13 Issue: №2 Pages: 394-400
Heading: Ophtalmology Article type: Original article
Authors: Kamenskikh T.G., Veselova E.V., Filatova V.S., Lyakhovich V.V., Golub' L.K., Karpenko A.A., Alekseyeva E.l., Kamenskikh I.D.
Organization: Saratov State Medical University
Summary:

The purpose of study is to evaluate the effectiveness of antiglaucomic operations with the use of the Ex-Press mini glaucoma shunt and Repegel-1 drainage in patients with primary open-angle glaucoma. Material and Methods. 65 patients (65 eyes) with an established diagnosis of uncompensated primary open-angle glaucoma of Stage III were observed. All patients underwent anti-glaucoma surgery. Patients of group 1 (15 patients, 15 eyes) underwent penetrating deep sclerectomy with implantation of the Ex-Press mini shunt under the scleral flap. Patients of group 2 (25 patients, 25 eyes) — penetrating deep sclerectomy with Repegel 1 drainage. Patients of group 3 (25 patients, 25 eyes) underwent sinus trabeculectomy without drainage. Results. In the early postoperative period, a good hypotensive effect was obtained in patients of all three groups. The most persistent antihypertensive effect was obtained in patients who underwent anti-glaucoma surgery with Repegel-1 drainage implantation. In patients who were implanted with the Ex-Press mini shunt, there was a significant decrease in the perimetrical MD index for 3 months. Conclusions. 1. Improvement of the photosensitivity of the retina in patients who underwent an antiglaucoma operation with Ex-Press shunt implantation, possibly due to the low invasiveness of the intervention and the absence of a sharp drop in IOP level. 2. Preliminary results (analysis 3 months after the operation) indicate a lower number of postoperative complications in the implantation of Repegel-1 drainage and a persistent hypotensive effect. 3. Patients who underwent antiglaucoma operations with implantation of drainage systems showed improvement of hemodynamic parameters in the pool of posterior short ciliary arteries in the postoperative period.

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Clinical and immunological parallels in the diagnosis of primary open-angle glaucoma.

Year: 2017, volume 13 Issue: №2 Pages: 378-383
Heading: Ophtalmology Article type: Original article
Authors: Kamenskikh I.D., Kamenskikh T.G., Kolbenev I.O., Zakharova N.B., Kozletsov A.P., Tuchin V.V.
Organization: Saratov State Medical University, Saratov state university, Yuri Gagarin State Technical University of Saratov
Summary:

The purpose of study is an assessment of the informative value of various diagnostic parameters in monitoring and prognosis of the state of the visual organ in patients with primary open-angle glaucoma. Material and methods. 216 patients (216 eyes) were examined. 126 patients (126 eyes) with the diagnosis of primary open-angle glaucoma I, II or III stage were included in the main group (I), and 90 patients (90 eyes) without ophthalmologic pathology were included in the control group (II). All patients underwent complex examination. Laser confocal scanning tomography for the analysis of the optic disc morphology was performed using a Heidelberg Retina Tomograph II from Heidelberg Engineering (Germany). Evaluation of the field of view was carried out using the computer static perimeter Oculus twinfield-2 (Germany). Electrophysiological studies (apparatus Roland Consult, Germany) included: the study of visual cortical potentials on the outbreak, the pattern-electroretinogram, photopic negative response. Neurotrophic brain factor, ciliary neurotrophic growth factor and protein NF-200, S-100 protein, monocyte chemoattractant, vascular endothelial growth factor were determined in the serum. Results. An increase in the concentration of the S-100 protein with progression of POAG testifies to the existence of parallels between apoptosis of retinal ganglion cells and systemic neurodegenera-tion affecting the central nervous system as a whole. The importance of electrophysiological research methods, which give information about the third neuron of the visual pathway, has been confirmed. Pattern-electroretinogram, photopic negative response most reflect abnormalities in the work of ganglion cells of the retina, including before the appearance of structural changes in the optic disc and the retina. Conclusion. The interrelation of dynamics of functional, morphological and immunological criteria of progression of POAG is revealed, which allows to predict the further course of the pathological process. Since the study involved patients with IOP target values, it is important not only to maintain IOP on target values, but also to carry out neuroprotection.

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Surgical method for prevention of scaring in conducting sinustrabeculectomy

Year: 2017, volume 13 Issue: №2 Pages: 372-375
Heading: Ophtalmology Article type: Original article
Authors: Zhuravleva A.N., Suleiman Е.А., Kiseleva О.А.
Organization: Moscow Helmholtz Research Institute of Eye Diseases
Summary:

Prolonged hypotensive effect in the postoperative period is one of the main tasks of modern glaucoma surgery. In connection with this, the aim of our study is to develop a surgical method of prevention of scarring during the classical sinustrabeculectomy. Material and Methods. The operation was performed in 13 patients (13 eyes) with primary open angle glaucoma (POAG) ll-lll (B-C) in steps aged 50-70 years. The duration of observation up of 2 year. Results. After 9-12 months of hypotensive efficacy was 100% (13 eyes) in 20-24 months — 98% (12 of 13 eyes). The result was confirmed using standard methods of examination (visometry, tonometry, computerized perimetry, tonography et al.), in the early postoperative period was performed optical coherence tomography of the anterior segment, then — ultrasound biomicroscopy. Conclusions. Developed a new version of the surgical treatment of glaucoma a long-acting hypotensive effect.

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Analysis of efficacy of travoprost with a preservative polyquad in the treatment of patients with primary open-angle glaucoma

Year: 2015, volume 11 Issue: №3 Pages: 337-341
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Petrova Yu.V., Veselova E.V.
Organization: Saratov State Medical University
Summary:

The purpose was to evaluate the efficacy and tolerability of travoprost and timolol use in the treatment of patients with initial stage of primary open angle glaucoma (POAG), as well as a preservative effect on the state of the cornea. Material and Methods. We observed 30 patients with a diagnosis of POAG first revealed. Group 1 patients (24 eyes) afforded 0.004% solution travoprost, patients in Group 2 (16 eyes) — 0.5% solution of timolol maleate. Patients in Group 1 who received travoprost with ВАК were administered travoprost with preservative polyquad in the same mode instillation. After 3 months after changing medication patients underwent examination of the cornea by laser scanning confocal imaging. Results. Intraocular pressure (IOP) in patients in Group 1 dropped from 33±3mm Hg. Article 18±2mm Hg.Art. In group 2, IOP decreased from 32±2mm Hg. to 21 ±1,5 mm Hg. Art. After 3 months of treatment with travoprost polyquad total number of epithelial cells of the cornea increased to 6231 ±415 cells/ mm2, signs of edema were not detected in 18 of 24 eyes in 6 cases, swelling of the corneal epithelium decreased, decreased number of "bright" keratocytes, endothelial cells well visualized and of hexagonal shape. Conclusion. Application of travoprost in patients with POAG provides a marked hypotensive effect compared with timolol. Application of travoprost with polyquad improves the state of the front layers of the epithelium and the corneal stroma of patients with glaucoma, reduced patients complaints to sensation of a foreign body and eye discomfort and redness.

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Evalutation of efficiency of dynamic laser magnetic stimulation of eye drainage system of patients with open angle glaucomatosis

Year: 2014, volume 10 Issue: №2 Pages: 336-340
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Sidelnikova V.S., Kamenskikh T.G.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to develop a comprehensive treatment aimed at improving uveoscleral outflow in the application of dynamic laser magnetic stimulation of the drainage system of the eye and evaluation of its effectiveness in treating patients with primary open-angle glaucoma (POAG). Material. 106 patients diagnosed POAG I, II, III stages were examined. Group 1 consisted of 62 patients treated with medical therapy and dynamic laser magnetic stimulation of the drainage system of the eye using the "AMO-ATOS-ICL", produced by JSC "TRIMA", Saratov. Group 2 consisted of 64 patients who received only medical therapy. Comprehensive survey including standard eye examination, static perimetry, visual evoked potentials study, the study of intraocular blood flow was conducted to all patients. Analysis of the results of the complex therapeutic effects showed that as the result of treatment 73% of patients had a decrease of intraocular pressure and the ease factor outflow increase. 52% of patients had a decrease in the number and area of relative. 63% of patients had activation of intraocular blood flow. These indices remained stable for three months. Conclusion. The treatment with the technique of dynamic laser magnetic stimulation of the drainage system of the eye of patients with primary open-angle glaucoma leads to lower intraocular pressure, and to the improvement of dopple-rographic and perimetric indications.

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