[Predicting the probability of development and progression of primary open angle glaucoma by regression modeling]. / Prognozirovanie veroiatnosti razvitiia i progressirovaniia pervichnoi otkrytougol'noi glaukomy metodom regressionnogo modelirovaniia.

Prediction of the clinical course of primary open-angle glaucoma (POAG) is one of the main directions in solving the problem of vision loss prevention and stabilization of the pathological process. Simple statistical methods of correlation analysis show the extent of each risk factor's impact, but do not indicate the total impact of these factors in personalized combinations. The relationships between the risk factors is subject to correlation and regression analysis. The regression equation represents the dependence of the mathematical expectation of the resulting sign on the combination of factor signs. PURPOSE: To develop a technique for predicting the probability of development and progression of primary open-angle glaucoma based on a personalized combination of risk factors by linear multivariate regression analysis. MATERIAL AND METHODS: The study included 66 patients (23 female and 43 male; 132 eyes) with newly diagnosed primary open-angle glaucoma. The control group consisted of 14 patients (8 male and 6 female). Standard ophthalmic examination was supplemented with biochemical study of lacrimal fluid. Concentration of matrix metalloproteinase MMP-2 and MMP-9 in tear fluid in both eyes was determined using 'sandwich' enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The study resulted in the development of regression equations and step-by-step multivariate logistic models that can help calculate the risk of development and progression of POAG. Those models are based on expert evaluation of clinical and instrumental indicators of hydrodynamic disturbances (coefficient of outflow ease - C, volume of intraocular fluid secretion - F, fluctuation of intraocular pressure), as well as personalized morphometric parameters of the retina (central retinal thickness in the macular area) and concentration of MMP-2 and MMP-9 in the tear film. CONCLUSION: The newly developed regression equations are highly informative and can be a reliable tool for studying of the influence vector and assessment of pathogenic potential of the independent risk factors in specific personalized combinations.

[Significance of anti-myelin basic protein antibodies for ocular hydrodynamic disturbances in primary open-angle glaucoma]. / Rol' antitel k osnovnomu belku mielina v narushenii gidrodinamiki pri pervichnoi otkrytougol'noi glaukome.

The aim of the study was to investigate the significance of anti-myelin basic protein (MBP) antibodies (AB) for ocular hydrodynamic disturbances in primary open-angle glaucoma (POAG). The study was conducted using the enzyme-linked immunosorbent assay (ELISA). The patients included had either high-tension (82 cases), or normal-tension (62 patients) glaucoma (HTG and NTG). In 46.3% of HTG patients and 38.7% of NTG patients, anti-MBP antibodies were lower than in the controls. There were also some cases (12.9%) of increased AB production at NTG onset. According to the canons of immunology, a decrease in anti-MBP antibodies can be explained by their binding to the protein and an increase - by stimulation of AB production through antigen release. In other words, antigen release must precede an increase in antibodies, which, in turn, must be followed by a subsequent decrease. In this aspect, an increase in anti-MBP antibody production at the stage of early hydrodynamic disturbances (NTG) and its decrease at the stage of pronounced changes (HTG) are perfectly natural. The level of anti-MBP antibodies correlated with the following indicators of ocular hydrodynamics: aqueous humor secretion (r=0.20841, p<0.05), intraocular pressure (r=-0.24046, р<0.05), ease of outflow (r=-0, 21552; р<0.05), and Becker's coefficient that reflects dissociation of control mechanisms in the regulation of hydrodynamics (r=-0.21683, p<0.05). The authors came to the conclusion that catalytic antibodies to MBP (also able to cause destruction of the myelin sheath of axons) play an important role in the pathogenesis of open-angle glaucoma. A decrease as well as an increase in anti-MBP antibodies has an unfavorable effect on ocular hydrodynamics. A theory has been put forward that these disorders may be induced by demyelination of peripheral nervous system axons involved in the regulation of intraocular fluid secretion and outflow.