[Effectiveness and safety of drug combination therapy in patients with advanced primary open-angle glaucoma]. / Effektivnost' i bezopasnost' kombinirovannoi terapii pervichnoi otkrytougol'noi glaukomy.

PURPOSE: To study the hypotensive effectiveness and safety of Bimoptic Plus (bimatoprost 0.03% + timolol 0.5%) in patients with developed primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 30 patients aged 57 to 72 years (45 eyes). The 1st group included 15 patients (24 eyes) who were first diagnosed with developed glaucoma with moderately elevated and high intraocular pressure (IOP) and prescribed the drug as starting therapy. Patients of the 2nd group (15 patients, 21 eyes) were prescribed Bimoptic Plus with insufficient effectiveness of monotherapy with prostaglandin analogues. The follow-up period was 6 months. RESULTS: The study was completed by 26 patients (41 eyes). Three patients (10%) has stopped using Bimoptic Plus due to side effects, one (3.3%) - due to insufficient hypotensive effect. In the 1st group, the maximum IOP decrease was recorded at the 1st month of the study and amounted to 8.34±1.47 mm Hg (32.2%) compared to baseline, while after 2 weeks, 3 and 6 months it decreased to 8.1±1.52 mm Hg (31.3%), 7.93±1.35 mm Hg (30.6%) and 7.9±1.42 mm Hg (30.5%), respectively. In patients of the 2nd group, additional IOP decrease after 2 weeks, 1, 3, and 6 months from the start of therapy was 4.68±1.24 mm Hg (20.5%), 4.94±1.18 mm Hg (21.7%), 4.55±1.23 mm Hg (20%), 4.5±1.26 mm Hg (19.7%), respectively. CONCLUSION: Bimoptic Plus effectively reduces the IOP level and has the least amount adverse reactions. It can be recommended for wide use in the treatment of patients with POAG.

[Evaluation of the effect of prostaglandin analogues and a carbonic anhydrase inhibitor/ß-blocker combination on the ocular blood flow in patients with primary open-angle glaucoma]. / Otsenka vliianiia analogov prostaglandina i kombinatsii ingibitora karboangidrazy s ß-blokatorom na glaznoi krovotok u patsientov s pervichnoi otkrytougol'noi glaukomoi.

PURPOSE: To assess the effect of latanoprost and fixed combination of dorzolamide/timolol on ocular hemodynamics in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study examined 34 patients (56 eyes) aged 51 to 69 years (average - 62.4±9.7 years) diagnosed with POAG in the initial (31 eyes) or advanced stage (25 eyes). Patients of the first group (20 patients, 36 eyes) were receiving latanoprost (Glauprost, Rompharm Company, Romania). The second group (14 patients, 20 eyes) was assigned to receive a fixed combination of dorzolamide/timolol (Dorzopt plus, Rompharm Company, Romania). Patient examination before and at 6 and 12 months included tonometry (ICare PRO), perimetry (Heidelberg Edge Perimeter), HRT and OCT of the optic nerve (Heidelberg Retina Tomograph 3 and Spectralis OCT2), as well as measurement of the density of surface (SVL) and deep (DVL) vascular plexus, and the Bruch's membrane opening minimum rim width (BMO-MRW). Additionally, we evaluated microcirculation in the choroid (MC) according to our original technique that uses Spectralis OCT2, and calculated rheographic index (RI) and stroke volume using transpalpebral rheoophthalmography. RESULTS: The decrease in IOP in the Latanoprost group was on average 27% and in the control group receiving timolol and dorzolamide - on average 22% and remained stable until the end of the study. The value of the area and volume of the disc rim band, BMO-MRW did not exhibit statistically significant changes in both groups by the 12th month of observation. A tendency to increase the RI from 51.5±24.5 to 62.2±19 (p=0.084) and the median of the index of microcirculation of the choroid (MC) from 16476 up to 23767 (p=0.062) in 1st group was observed. CONCLUSION: The study confirms the feasibility of using latanoprost and a fixed combination of dorzolamide and timolol in ocular hypotensive therapy of glaucoma thanks to their pronounced hypotensive effect. Patients were noted to have a tendency for improvement of ocular hemodynamics when using latanoprost.

[Efficacy and safety of travoprost in patients with primary open-angle glaucoma]. / Éffektivnost' i bezopasnost' preparata 'Travapress' u patsientov s pervichnoi otkrytougol'noi glaukomoi.

PURPOSE: To study the hypotensive efficacy and safety of Travapress (0.004% travoprost) in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 50 patients (91 eyes) aged 45 to 74 years. The first group consisted of 23 patients (41 eyes) who received monotherapy with Travaprost. Patients of the second group (27 patients, 50 eyes) Travaprost was added to therapy with timolol 0.5% (17 patients, 32 eyes) or dorzolamide 2% (10 patients, 18 eyes). Travaprost was given for a period of 6 months. IOP was determined in 2 weeks, 1, 3 and 6 months from the beginning of treatment and daily IOP measurement was at 10.00, 12.00, 14.00 and 16.00. Subjective symptoms were evaluated in points by special scales. RESULTS: The study was completed by 42 patients (84%, 79 eyes). Two patients (4.7%) has stopped to use Travapress due to the side effects. Local side effects were observed in 9 patients (21.4%) with mild hyperemia being the most common and seen in 5 patients (11.9%). In the first group, the maximum IOP decrease was recorded for 3 months of the study and amounted to 7.3±1.2 mm Hg (27.5%) compared to baseline. By 6 months, IOP decreased by 6.8±1.5 mm Hg on average (25.6%). In the second group in the subgroup with timolol 0,5% IOP decreased by 4,9±1.7 mm Hg (20%) compared to baseline, in the subgroup with dorzolamid 2% - by 4,3±1,3 mm Hg (16,9%) compared to baseline. Evening use the drug was accompanied by significantly lower levels of daily IOP fluctuations compared with morning intake (3.0±1.2 and 3.8±1.7 mm Hg, respectively, p = 0,002). CONCLUSION: Travapress was established as highly efficient and safe. It can be recommended for wide use in the treatment of patients with POAG.

[Experimental study of cytokines complex inhibitory effect on wound healing after glaucoma filtering operations: histopathological and immunochemical findings]. / Ingibiruiushchee vliianie kompleksa tsitokinov na zazhivlenie ran posle glaukomofil'truiushchei operatsii v éksperimente.

Experiments on a model of glaucoma filtering operation in 25 rabbits showed that the natural cytokine complex inhibited the operation wound healing in comparison with the control. The complex was prepared by an original method (culturing peripheral blood leukocytes) at Immunology Department of the Russian State Medical University. Histopathological study revealed delayed formation of cicatricial tissue under the effect of cytokines. Decreased proliferation of fibroblasts and their decreased functional activity (decreased synthetic activity of glycosaminoglycanes and collagen) was detected in cicatricial tissue. Immunohistochemical studies showed that in remote periods (after 3-8 months) type IV membrane collagen formed in new cicatricial tissue, while in the control, types III and I collagens predominated in cicatricial tissue. Immunohistochemical structure of the cicatrix in experiment correlated with fine fibrous structure of cicatricial tissue, characterized by high permeability. Possible mechanisms of the inhibitory effect of the natural cytokine complex on the course of operation wound healing after glaucoma-filtering surgery are discussed.