[Role of point-by-point light sensitivity in the assessment of glaucoma progression]. / Rol' potochechnoi svetochuvstvitel'nosti v otsenke progressirovaniya glaukomy.

PURPOSE: This study analyzes changes in light sensitivity in each test point of the visual field in patients with different stages of glaucoma. MATERIAL AND METHODS: The data of a prospective analytical case-control study were analyzed. All patients underwent assessment of retinal light sensitivity and its variability in 54 points corresponding to the 24-2 program. Mean light sensitivity values were calculated in each point. Intergroup analysis was performed to evaluate changes in light sensitivity in each point. RESULTS: The range of light sensitivity decrease in the early glaucoma group compared to the control group was from 1.5 to 3.6 dB. The range of light sensitivity decrease in the moderate glaucoma group compared to the control group was from 2.1 to 11.5 dB, and compared to the early glaucoma group - from -0.9 to 7.9 dB. The most frequent decrease in light sensitivity was detected in the nasal sector and along the horizontal line in the upper half of the visual field. This trend persisted within the central 10 degrees of the visual field. The range of light sensitivity decrease in the advanced glaucoma group compared to the control group was from 14.1 to 28.0 dB, and compared to the early glaucoma group - from 11.35 to 26.08 dB, compared to the moderate glaucoma group - from 9.1 to 23.5 dB. The most frequent and severe decrease in light sensitivity was detected in the paracentral zone in the lower half of the visual field. CONCLUSION: The study analyzed the trends in the development of glaucoma from the early to the advanced stage. The most frequent and severe defect in light sensitivity in cases of verified advanced glaucoma was found in the lower half of the visual field. Points No. 32, 33 and 40 can be indicated as the area of interest in assessing the progression of glaucoma, as they were found to have the most profound changes in light sensitivity as glaucoma progressed.

[Thresholds and variability of retinal light sensitivity in each point of the examined visual field]. / Porogovye znacheniya i variabel'nost' svetochuvstvitel'nosti setchatki v kazhdoi tochke issleduemogo polya zreniya.

PURPOSE: This study assesses the light sensitivity and its variability in each point of the visual field in patients without glaucoma and with different stages of glaucoma. MATERIAL AND METHODS: The data of a prospective analytical case-control study involving 500 patients were analyzed. The initial examination of all patients was performed using basic ophthalmological methods, including static perimetry. Retinal light sensitivity and its variability were assessed in 54 points corresponding to the Humphrey 24-2 program. Mean deviation and pattern standard deviation of light sensitivity were calculated for each point. RESULTS: The lowest light sensitivity values in patients with moderate glaucoma were found in the periphery of the nasal sector, at point No. 27 - 14.4 dB, and at points No. 24-26 along the horizontal axis from the nasal side - from 17.7 to 22.7 dB. The maximum variability of light sensitivity was found in the nasal sector on both sides of the horizontal line - from 10.7 to 11.5 dB. The average light sensitivity above the horizontal axis in patients with advanced glaucoma was 10.8 dB, which is 2 dB higher than in the lower half of the visual field - 8.8 dB. The highest light sensitivity values were found at points No. 24 - 17.7 dB and No. 31 - 16.78 dB, the lowest - at point No. 32 - 4.5 dB. The average variability values of light sensitivity in the upper half of the visual field were 9.6 dB, which is 1 dB less than in the lower half of the visual field - 10.6 dB. CONCLUSION: According to our data, points No. 32 and No. 40 are of particular interest in the diagnostic plan. In these loci, the highest light sensitivity values were determined in early and moderate glaucoma. However, the values in these points decrease significantly in advanced glaucoma. It can be assumed that changes in light sensitivity in these loci at the early stages of glaucoma may be a predictor of glaucoma progression.

[Static automated perimetry in the diagnosis of glaucoma. Assessment of disease progression]. / Staticheskaya perimetriya v diagnostike glaukomy. Sposoby otsenki progressirovaniya.

There are several ways to assess glaucoma progression using standard automated perimetry. Most often, ophthalmologists evaluate the stability of visual functions manually when comparing several study protocols. The advantages of clinical assessment are ease of implementation and the ability to interpret data from any device. The main disadvantage of this method is its subjectivity. There are many available automated methods for assessing disease progression involving Humphrey Field Analyzer and Octopus perimeters. Event analysis allows determining glaucoma progression at the time of examination, with consideration of the possible physiological fluctuations in light sensitivity. Trend analysis of perimetric indices makes it possible to assess the rate of glaucoma progression and forecast the trend of changes in visual functions over the next five years. All these methods for assessing progression have certain advantages and disadvantages and cannot be considered ideal. Pointwise and cluster trend analysis are more sensitive in early glaucoma and are being actively researched and developed. These methods have great potential, although they are not yet sufficiently available in clinical practice.

[The effect of body position on the results of central and paracentral rebound tonometry]. / Vliyanie polozheniya tela na rezul'taty tochechnoi kontaktnoi tonometrii v tsentre i na periferii rogovitsy.

PURPOSE: This study analyzes the fluctuations of intraocular pressure (IOP) and clarifies the error of paracentral rebound tonometry associated with change in body position. MATERIAL AND METHODS: The study included 45 healthy volunteers aged 25.4±2.1 years. First we performed rebound tonometry in the sitting position in the center of the cornea and 3-4 mm from the temporal and nasal sides (Icare-c, Icare-n, Icare-t, respectively) and bidirectional applanation tonometry (IOPcc - corneal compensated, IOPg - Goldmann tonometry). Then we measured Icare-c, Icare-n, Icare-t in the supine position, and after 5 minutes repeated Icare-c in the supine position. After this, we measured Icare-c, IOPcc and IOPg in the sitting position. RESULTS AND DISCUSSION: Initial IOPcc and IOPg were 4.6±2.8 and 14.8±2.8 mm Hg. Initial Icare-c, Icare-t, and Icare-n measurements amounted to 15.0±1.9, 15.7±1.5 and 16.3±1.3 mm Hg; in the supine position the measurements were 16.4±2.1, 17.2±1.7 and 17.1±1.9 mm Hg. Paracentral measurements differed from Icare-c in both sitting and supine positions; only between Icare-t and Icare-n measured in the supine position there were no significant differences. The results of Icare-c, Icare-t, and Icare-n in body position change were comparable. Icare-c measured after 5 minutes in the supine position increased up to 16.6±2.4 mm Hg. Final IOPcc and IOPg did not differ from the initial measurements. Final Icare-c was lower than the initial result by 0.8±0.2 mm Hg, and lower than both supine Icare-c measurements by 2.1±0.2 and 2.6±0.2 mm Hg. CONCLUSION: Paracentral rebound tonometry findings exceed those of rebound tonometry in central cornea, but in body position change the alteration of measurements in the same points on the cornea are comparable. In the supine position IOP increases on average by 1.0-1.5 mm Hg compared to the sitting position.

[Effectiveness and safety of a hypotensive preservative-free drug in long-term therapy of glaucoma]. / Effektivnost' i bezopasnost' primeneniya gipotenzivnogo beskonservantnogo preparata pri dlitel'noi terapii glaukomy.

PURPOSE: To investigate the condition of the ocular surface and the effectiveness of Taflotan for long-term therapy in patients with newly diagnosed primary open-angle glaucoma in real clinical practice. MATERIAL AND METHODS: This publication presents data form a retrospective observational study that analyzed newly diagnosed glaucoma patients that have been using 1 drop/day of Taflotan in the evening for 12 months. All patients were examined at baseline, and after 1 month and 12 months of treatment, recording intraocular pressure (IOP), retinal photosensitivity indicators (MD, PSD), thickness of the retinal nerve fiber layer (RNFL), and assessing the condition of the ocular surface by Schirmer test, tear breakup time (TBUT), ocular surface disease index (OSDI) questionnaire, as well as measurement of the lacrimal meniscus height and corneal staining with lissamine green. RESULTS: IOP effectively decreased in all patients using Taflotan, reaching the target pressure by 1 month after therapy initiation. IOP decreased from 25±4 mm Hg at baseline to 17±3mm Hg after 1 month with further decrease down to 16±3 mm Hg after 12 months of therapy. Retinal photosensitivity (MD and PSD) and RNFL thickness did not differ from baseline, and correlated to glaucoma stage. The indicators of the condition of the ocular surface had no significant differences between the baseline, 1-month and 12-month time points. CONCLUSION: Taflotan effectively decreases IOP in newly diagnosed glaucoma patients, maintains stable automated perimetry indices and RNFL thickness, and does not affect the ocular surface throughout 12 months of therapy.

[Static automated perimetry in the diagnosis of glaucoma. Part 1: Basic principles]. / Staticheskaya perimetriya v diagnostike glaukomy. Chast' 1. Bazovye printsipy.

Static automated perimetry is an indispensable tool in the diagnosis of glaucoma. It is used to study the differential light sensitivity of the retina in different points of the visual field. The most important is the central zone of the visual field, many perimetric programs and strategies have been developed for its examination. Using standard background brightness, we can vary sizes, location methods and the type of stimulus delivery. The proper use of standard achromatic perimetry is crucial for the correct management of glaucoma patients. This review analyzes literature on the basic principles of static perimetry in the examination of differential photosensitivity of the retina.

[Static automated perimetry in the diagnosis of glaucoma. Part 2: Research protocol, glaucoma classifications, perimetric defects through the prism of structural-functional correlation]. / Staticheskaya perimetriya v diagnostike glaukomy. Chast' 2. Protokol issledovaniya, klassifikatsii glaukomy, perimetricheskie defekty cherez prizmu strukturno-funktsional'noi korrelyatsii.

Examination of the central visual field is currently required for glaucoma diagnosis. Modern computer perimeters make it possible to qualitatively and quantitatively evaluate defects of light sensitivity. Perimetric indices are calculated showing the severity of the defects. This allows the use of perimetric results to create universal classifications of glaucoma. Recently, new perimeter programs based on optical coherence tomography data have appeared. The possibility of personalizing perimeter programs are being tested. This review attempts to systematize data on the capabilities of computer perimeters in assessing functional defects, presents the widely used glaucoma classifications, and describes ways of developing static perimetry programs for earlier diagnosis of glaucoma with respect to structural and functional correlations.