[Glaucoma dynamics in patients who followed monitoring and treatment instructions and in those who didn't].

Clinical course of different stages of primary open-angle glaucoma (POAG) is studied in 216 patients (432 eyes) who followed monitoring and treatment instructions during 13 years and in those who didn't. In patients who did not follow recommendations glaucoma progression was found in 99,4% of patients with initial disease, in 48,7% of cases with advanced stage and in 50% of patients with the end stage of the disease. Patients who followed recommendations of general ophthalmologists and glaucomatologists showed stable course of glaucoma process in 1 patient (0,6%) with initial stage, in 51,3% of patients with advanced stage and in 50% of patients with the end stage of the disease.

[Condition of ocular blood supply in patients with primary open-angle glaucoma with normal pressure]. / Sostoianie krovosnabzheniia glaz u bol'nykh pervichnoi otkrytougol'noi glaukomoi s normal'nym davleniem.

The condition of discharge of intraocular fluid (IOF), the value of systemic arterial pressure (AP), the condition of mean dynamic arterial pressure in the ocular artery (Pm.ophth.) an the perfusion ocular pressure (Pperf.) were examined in patients with normal pressure glaucoma (NPG). A decrease in the IOF discharge from 0.16 +/- 0.02 cu mm per 1 mm Hg at the NPG initial stage to 0.11 +/- 0.01 cu mm per 1 mm Hg at the NPG deteriorated stage was established. The value of decrease of the systemic AP within an interval of 100 to 116 mm Hg is observed in patients with NPG by 6.9 times more often as compared to the controls (in 42.2% and 6.1% of cases, respectively). A reliable reduction of Pm.ophth. by 4.0 mm Hg and of Pperf.--by 4.9 mm Hg was found in patients with NPG as compared with Pm.ophth. and Pperf. in the controls with the same systemic AP values; the deficit of the ocular volumetric blood flow reached 10.9%. The treatment of NPG patients must be related with improving the IOF discharge, with reducing the genuine intraocular pressure (Po) to a tolerable level, and with increasing the systemic AP, Pm.ophth. and Pperf. to the mean statistically normal level.

[Arterial pressure in the orbital artery and eye perfusion in patients with different stages of primary open-angle glaucoma]. / Arterial'noe davlenie v glaznichnoi arterii i perfuziia glaza u bol'nykh s razlichnymi stadiiami pervichnoi otkrytougol'noi glaukomy.

A total of 902 patients aged 40-82 years (1804 eyes) with primary open-angle glaucoma (POAG) with different stages of the disease and different intraocular pressure (IOP) and systemic arterial pressure (AP) 105-170 mm Hg were examined. Control group consisted of 340 age-matched normal subjects (680 eyes) with the same values of AP. Systemic AP affected the mean dynamic and perfusion pressure (Pm.ophth. and Pperf.) in both normal subjects and patients with POAG. In addition, both parameters in POAG patients depended on IOP and duration of the glaucomatous process. An increase of IOP was paralleled by a compensatory increase of Pm.ophth., but the higher IOP (an increase within the b-c interval), the less pronounced the increase of Pm.ophth., particularly in patients with well-developed and advanced stages. A progressive decrease of Pperf. was observed, which was related to high IOP and duration of the glaucomatous process.

[Status of blood supply to the eye in patients with primary open-angle glaucoma depending on the value of systemic arterial pressure and level of ophthalmic tone]. / Sostoianie krovosnabzheniia glaz u bol'nykh pervichnoi otkrytougol'noi glaukomoi v zavisimosti ot velichiny sistemnogo arterial'nogo davleniia i urovnia oftal'motonusa.

Blood supply to the eye was studied in 756 patients aged 40-82 years (1339 eyes) with primary open-angle glaucoma, systemic arterial pressure (AP) 105-170 mm Hg, and various level of intraocular pressure (IOP). Control group consisted of 340 healthy subjects (680 eyes) aged 28-80 years without ophthalmic diseases with the same AP values. Blood supply values in the controls were taken for the norm. They were in high correlation with systemic AP. Ocular blood supply in patients with primary open-angle glaucoma depends on systemic AP and IOP, particularly perfusion pressure (Pperf) which decreases by 3.1 mm Hg in patients with systemic AP of 126-139 mm Hg and moderately (from normal to moderate) increased IOP. If IOP increases in the interval from moderate to high in patients with the same AP, Pperf drops by 12.5 mm Hg. Pperf values indicate deterioration of ocular blood supply in patients with primary open-angle glaucoma and different levels of IOP.

[Ophthalmodynamography in studies of ocular hemodynamics in normal subjects of different age with different arterial pressure]. / Oftal'modinamografiia v izuchenii gemodinamiki glaz u zdorovykh lits v zavisimosti ot vozrasta i urovnia arterial'nogo davleniia.

Computer-aided ophthalmodynamographer for studies of hemodynamics in the orbital artery has been elaborated at research and production firm All-Russian Institute of Medical Engineering--Optimed. A total of 292 healthy subjects (542 eyes) aged 28-77 years with systolic pressure 100-170 mm Hg were examined. Main hemodynamic parameters in the orbital artery were determined: systolic, diastolic, mean ophthalmic, perfusion pressure, and systolic increment in pulse volume. Ocular hemodynamic parameters, except systolic increment in pulse volume, directly depend on systemic arterial pressure but not on age. Normal parameters of systolic, diastolic, mean ophthalmic, and perfusion pressure in the orbital artery at certain levels of systemic arterial pressure were determined.

[The dynamics of the glaucoma process based on data from prolonged ambulatory care of patients]. / Dinamika glaukomnogo protsessa po dannym dlitel'noi dispanserizatsii bol'nykh.

On the basis of a prolonged dispensary observation (from 14 to 27 years) over 107 patients, the authors have studied timeliness of therapeutic and surgical treatment, dynamics of glaucomatous process after 3, 6, 9, 12, 15, 18, 21-27 years. In the beginning of the observation, initial and advanced stages (88.5%) with a moderate rise of intraocular pressure (69%) prevailed. With prolongation of observation, initial stages regularly turn into subsequent ones, sometimes in the presence of normal values of intraocular pressure. Stabilization of glaucomatous process was most frequently observed in patients who had underwent regular complex medicamentous therapy and timely surgical treatment. Glaucoma of stage I most frequently turns into more advanced stages with decreased visual functions within first three years. Therefore, it is in this period when patients should be subjected to thorough dispensary observation, timely refer to in-patient's treatment, and the question about surgical treatment be decided in early terms.