[New morphometric criteria in the study of pathogenesis of normal-tension glaucoma]. / Novye morfometricheskie kriterii v izuchenii patogeneza glaukomy normal'nogo davleniya.

INTRODUCTION: Studying the factors that contribute to the disturbance of transmembrane pressure gradient is a topical task in the research of pathogenesis of normal-tension glaucoma (NTG). PURPOSE: To measure and compare the thickness and depth of lamina cribrosa (LCT and LCD), as well as optic nerve subarachnoid space width (ONSASW) in patients with NTG and healthy individuals. MATERIAL AND METHODS: The first group included 12 patients (23 eyes) aged from 58 to 74 years (average age 66.8±3.2 years) with NTG who all had normal intraocular pressure and arterial hypotension. The second (control) group consisted of 11 healthy individuals (22 eyes) aged from 51 to 69 years (average age 56.2±4.2 years). All patients underwent structural and functional assessment of the optic nerve head using OCT RTVue-100 (Optovue, USA), as well as Humphrey Visual Field Analyzer (HFA II 745i, Germany-USA) and our modification of Frequency Doubling Technology perimetry. In all subjects the central corneal thickness (CCT) was measured by Pentacam HR (Oculus, Germany), the LCT and LCD were measured by EDI (Enhanced Depth Imaging) mode of Topcon 3D OCT 2000 (Japan). To measure the ONSASW we used a cross-sectional image of the optic nerve taken 3 mm behind the eyeball with Magnetic Resonance Imaging (Siemens Magnetom Symphony 1.5 T, Germany). RESULTS: Statistically significant difference was found between the 1st and 2nd groups in the average LCT (217.60±36.92 and 345.86±33.29 µm respectively; p=0.0000), LCD (435.00±86.31 and 367.31±87.00 µm, respectively; p=0.014) and ONSASW (1.27±0.13 and 1.44±0.19 mm respectively; p=0.004); the difference wasn't significant in the average CCT (543.26±31.52 and 557.50±24.92 µm respectively; p=0.11). CONCLUSION: Patients with NTG had significantly higher value of the LCD with significantly lower values of the LCT and ONSASW compared with healthy individuals, which confirms the importance of these morphometric criteria in the study of NTG pathogenesis.

[Dry eye syndrome in patients with primary open-angle glaucoma].

AIM: to determine the frequency and severity of dry eye syndrome (DES) in primary open-angle glaucoma (POAG) patients that are newly diagnosed or already receiving beta blocker instillation therapy. MATERIAL AND METHODS: A total of 127 patients (190 eyes) with POAG were divided into two groups. Group 1 included 55 newly diagnosed patients (88 eyes), group 2-72 POAG patients (102 eyes) instilling timolol 0.5% twice daily into the affected eye. The control group included 20 patients (40 eyes) aged 60-88 years (73.6 ± 9.2 years on average) with early age-related cataract. RESULTS: DES was found in 69 POAG patients (79%) who was just starting their topical hypotensive therapy and 85 of those (84%) under treatment (p = 0.39). CONCLUSIONS: One should take into account when prescribing ocular hypotensive therapy that newly diagnosed POAG patients usually already suffer from a dry eye. The use of topical beta blockers that contain preservatives exacerbates dry eye signs and symptoms in these patients.

[Impact of cataract and age-related macular denegeration on the results of various perimetry techniques].

The purpose of the investigation is to study the impact of cataract and age-related macular degeneration (AMD) on the results of frequency-doubling technology (FDT) perimetry. Three groups of patients over 40 years of age took part in the clinical trial: 1) patients with cataract only; 2) those with cataract and glaucoma; 3) those with AMD. A control group comprised healthy individuals. Group 1 and 2 patients underwent phacoemulsification (PE) with intraocular lens implantation. Humphrey (HFA) static threshold testing (24-2) (HFA perimetry) and the authors' modified FDT perimetry were used before and 3 to 6 months after surgery. Group 3 patients also underwent microperimetry and optic coherence tomography. Cataract with visual acuity 8/ 20 or worse decreased very similar perception according to the results of FDT perimetry and HFA perimetry. FDT perimetry revealed more scotomas in patients with cataract concurrent with glaucoma. HFA II perimetry was more sensitive in detecting AMD. AMD and visual acuity of 4/20 or worse decreased contrast perception in some central squares of FDT perimetry.

[High-technological screening for glaucoma].

The purpose of the article is to investigate the effectiveness (sensitivity and specificity) of the screening test of the FDT perimetry in early diagnostic of glaucoma in mass prophylactic examinations of population and in patients with glaucoma at the ophthalmic sections of some military hospitals. Data were obtained from 700 eyes of 350 persons older than 40 years including 33 patients (53 eyes) with open angle glaucoma (OAG) which were examined at the ophthalmic sections of 5 military hospitals. The threshold test of the FDT perimetry was re-created as a computer programmer. The screening test of the FDT perimetry was made on principles of the threshold test of the FDT perimetry and is intended for mass prophylactic examinations of population especially in groups of glaucoma risk. In this investigation our version of the screening test of the FDT perimetry showed high sensitivity (94.4%) and specificity (95.3%) in early diagnostic of glaucoma.

[Visocontrastometry as one of diagnostic criteria for early detection of glaucoma and evaluation of stabilization of glaucomatous process]. / Vizokontrastometriia kak odin iz diagnosticheskikh kriteriev v rannem vyiavlenii glaukomy i v otsenke stabilizatsii glaukomatoznogo protsessa..

The relationship between contrast-frequency characteristics of the eye, on the one hand, and visual acuity and peripheral field, photosensitivity in the central visual field, ophthalmic tone, and area of the optic disk neuroretinal zonule, on the other, was for the first time evaluated by regression-correlation analysis. Videograms averaged for groups with consideration for glaucoma stage and changes in visual acuity in each group were compared. The sensitivity and specificity of visocontrastometry for early detection of glaucoma and evaluation of stabilization of the glaucomatous process were assessed. Based on the results, the author formulated her suggestions supplementing the classification of primary glaucoma currently used in Russia.