Pub Date : 2021-09-20DOI: 10.53432/2078-4104-2021-20-3-21-29
L. Grigoryan, I. Simakova, A. Kuroyedov
PURPOSE. To study the needs of practical ophthalmologists concerning the functionality and performance of automatic perimeters, and offer a possible solution to meet these needs.METHODS. An online survey of Russian ophthalmologists was organized and conducted. The survey was attended by specialists representing various medical institutions and medical research centers. As a result of the survey, 132 filled questionnaire forms were received and analyzed using the Kano and 4C models.RESULTS. According to experts, it is necessary for ophthalmologists to have an accessible automatic perimeter equipped with the screening (for the initial examination of patients) and threshold (to clarify the depth of photosensitivity disturbance of detected visual field defects) strategies. The general requirements for the functional characteristics of the screening and threshold tests of the automatic perimeter have been determined: small variability of repeated results, the speed and simplicity of the study — particularly, by employing the Frequency Doubling Technology (FDT), a non-standard perimetry technique. The requirements of users for the operational method of the automatic perimeter have been determined: absence of the need for a specially prepared room and place, mobility, portability, maximum ease of use to ensure the possibility of performing screening and primary diagnostics outside medical institutions, including by mobile medical teams, and also to allows examinations of individuals with disabilities, including bedridden patients, both in the hospital and at home.CONCLUSION. Based on the study data, the needs of ophthalmologists in the functional and operational characteristics of modern automatic perimeters were identified showing that the automatic perimeters presently used by modern medical institutions are far from optimal in terms of their properties/characteristics. These devices do not allow perimetry to be performed on patients with disabilities, including bedridden patients, neither at home nor in the hospitals. In addition, these devices require a darkened room, they are difficult to use, while their licensing documentation states that only ophthalmologists can conduct the examinations. Manufacturers do not offer solutions tailored to the individual needs of specific user groups — outpatient ophthalmologists who in particular work with disabled patients.
{"title":"Perimetry as a technique from the standpoint of practicing ophthalmologists","authors":"L. Grigoryan, I. Simakova, A. Kuroyedov","doi":"10.53432/2078-4104-2021-20-3-21-29","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-3-21-29","url":null,"abstract":"PURPOSE. To study the needs of practical ophthalmologists concerning the functionality and performance of automatic perimeters, and offer a possible solution to meet these needs.METHODS. An online survey of Russian ophthalmologists was organized and conducted. The survey was attended by specialists representing various medical institutions and medical research centers. As a result of the survey, 132 filled questionnaire forms were received and analyzed using the Kano and 4C models.RESULTS. According to experts, it is necessary for ophthalmologists to have an accessible automatic perimeter equipped with the screening (for the initial examination of patients) and threshold (to clarify the depth of photosensitivity disturbance of detected visual field defects) strategies. The general requirements for the functional characteristics of the screening and threshold tests of the automatic perimeter have been determined: small variability of repeated results, the speed and simplicity of the study — particularly, by employing the Frequency Doubling Technology (FDT), a non-standard perimetry technique. The requirements of users for the operational method of the automatic perimeter have been determined: absence of the need for a specially prepared room and place, mobility, portability, maximum ease of use to ensure the possibility of performing screening and primary diagnostics outside medical institutions, including by mobile medical teams, and also to allows examinations of individuals with disabilities, including bedridden patients, both in the hospital and at home.CONCLUSION. Based on the study data, the needs of ophthalmologists in the functional and operational characteristics of modern automatic perimeters were identified showing that the automatic perimeters presently used by modern medical institutions are far from optimal in terms of their properties/characteristics. These devices do not allow perimetry to be performed on patients with disabilities, including bedridden patients, neither at home nor in the hospitals. In addition, these devices require a darkened room, they are difficult to use, while their licensing documentation states that only ophthalmologists can conduct the examinations. Manufacturers do not offer solutions tailored to the individual needs of specific user groups — outpatient ophthalmologists who in particular work with disabled patients.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130623747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-17DOI: 10.53432/2078-4104-2021-20-3-3-10
A. Chuprov, A. O. Lositskiy, V. A. Trubnikov, Т. N. Kazakova
PURPOSE. To study the epidemiological features of glaucoma prevalence among the population of the Russian Federation and to assess the organization of primary specialized medical care for patients with this pathology.MATERIALS AND METHODS. The subject of this study was the population of the Russian Federation diagnosed with glaucoma. In order to assess the epidemiological features of glaucoma prevalence and to assess the organization of primary specialized medical care for patients with this pathology, according to the federal statistical reporting forms (Forms No. 12, No. 30), the following indicators were calculated: overall and primary incidence of glaucoma in the general population; proportion of patients with glaucoma who are registered with ophthalmologists; availability of ophthalmologists (individuals) per 100 thousand population; proportion of patients with glaucoma diagnosis established during preventive examinations; total number of registered patients with blindness and visual impairment. Statistical processing of the material involved methods of descriptive statistics; calculation of average and relative values with a preliminary assessment of the distribution of indicators for normality. Spearman rank correlation method was used to determine the correlation between quantitative variables.RESULTS. The studied data was used to calculate the following average values: total and primary glaucoma incidence among the population of the Russian Federation — 78.2 (55.8–105.3) cases per 100 thousand population; the proportion of patients with dispensary registered glaucoma — 80% (74.4–85.8%). The performed correlation analysis established a moderate direct statistically significant relationship between the indicators of total and primary glaucoma incidence among the population (rank correlation coefficient: r=0.72 at p<0.05). In its turn, the correlation between the indicators of glaucoma incidence among the population and the availability of ophthalmologists for the population has not been established (r=0.14, p>0.05). It was found that the indicators of dispensary observation of glaucoma patients do not depend on the indicators of total glaucoma incidence (r=0.16) and availability of ophthalmologists for the population (r=0.13). There is a weak inverse correlation between the proportion of glaucoma cases detected during preventive examinations and the indicator of primary glaucoma incidence among the population (r=-0.28; p<0.05). Also, the correlation analysis did not establish a relationship between the indicator of total glaucoma incidence among the population and the total number of registered patients with blindness and low vision (r=-0.008).CONCLUSION. The incidence rate of glaucoma in specific administrative territories should be assessed by comparison with the average values among the whole population, which are represented by the median and quarterly ranges. The incidence rate of glaucoma in the general population is not statisticall
{"title":"Epidemiological features of glaucoma prevalence among the population of the Russian Federation","authors":"A. Chuprov, A. O. Lositskiy, V. A. Trubnikov, Т. N. Kazakova","doi":"10.53432/2078-4104-2021-20-3-3-10","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-3-3-10","url":null,"abstract":"PURPOSE. To study the epidemiological features of glaucoma prevalence among the population of the Russian Federation and to assess the organization of primary specialized medical care for patients with this pathology.MATERIALS AND METHODS. The subject of this study was the population of the Russian Federation diagnosed with glaucoma. In order to assess the epidemiological features of glaucoma prevalence and to assess the organization of primary specialized medical care for patients with this pathology, according to the federal statistical reporting forms (Forms No. 12, No. 30), the following indicators were calculated: overall and primary incidence of glaucoma in the general population; proportion of patients with glaucoma who are registered with ophthalmologists; availability of ophthalmologists (individuals) per 100 thousand population; proportion of patients with glaucoma diagnosis established during preventive examinations; total number of registered patients with blindness and visual impairment. Statistical processing of the material involved methods of descriptive statistics; calculation of average and relative values with a preliminary assessment of the distribution of indicators for normality. Spearman rank correlation method was used to determine the correlation between quantitative variables.RESULTS. The studied data was used to calculate the following average values: total and primary glaucoma incidence among the population of the Russian Federation — 78.2 (55.8–105.3) cases per 100 thousand population; the proportion of patients with dispensary registered glaucoma — 80% (74.4–85.8%). The performed correlation analysis established a moderate direct statistically significant relationship between the indicators of total and primary glaucoma incidence among the population (rank correlation coefficient: r=0.72 at p<0.05). In its turn, the correlation between the indicators of glaucoma incidence among the population and the availability of ophthalmologists for the population has not been established (r=0.14, p>0.05). It was found that the indicators of dispensary observation of glaucoma patients do not depend on the indicators of total glaucoma incidence (r=0.16) and availability of ophthalmologists for the population (r=0.13). There is a weak inverse correlation between the proportion of glaucoma cases detected during preventive examinations and the indicator of primary glaucoma incidence among the population (r=-0.28; p<0.05). Also, the correlation analysis did not establish a relationship between the indicator of total glaucoma incidence among the population and the total number of registered patients with blindness and low vision (r=-0.008).CONCLUSION. The incidence rate of glaucoma in specific administrative territories should be assessed by comparison with the average values among the whole population, which are represented by the median and quarterly ranges. The incidence rate of glaucoma in the general population is not statisticall","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125456325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.53432/2078-4104-2021-20-2-57-65
S. Anisimov, S. Anisimova, L. Arutyunyan, A. Voznyuk
Glaucoma is a socially significant disease and ranks first among the causes of visual impairment and blindness. Glaucoma is a chronic disease with progressive course, and the entire treatment and diagnostic process is associated with the need for constant monitoring of the structural and functional components of the visual system to assess the progression of glaucomatous optic neuropathy. With adequately chosen treatment tactics, it is possible to stabilize the glaucomatous process and successfully reverse the structural and functional changes thanks to the links between functional defects of the visual fields and topographic damage in the optic nerve with the stage of the disease. This statement emphasizes the need to choose the correct treatment tactics, as well as to closely monitor the structural and functional characteristics of patients with glaucoma. In this regard, the issue of studying the safety and effectiveness of various glaucoma surgeries depending on observation time remains relevant.
{"title":"Evaluation of the effectiveness of glaucoma surgeries","authors":"S. Anisimov, S. Anisimova, L. Arutyunyan, A. Voznyuk","doi":"10.53432/2078-4104-2021-20-2-57-65","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-57-65","url":null,"abstract":"Glaucoma is a socially significant disease and ranks first among the causes of visual impairment and blindness. Glaucoma is a chronic disease with progressive course, and the entire treatment and diagnostic process is associated with the need for constant monitoring of the structural and functional components of the visual system to assess the progression of glaucomatous optic neuropathy. With adequately chosen treatment tactics, it is possible to stabilize the glaucomatous process and successfully reverse the structural and functional changes thanks to the links between functional defects of the visual fields and topographic damage in the optic nerve with the stage of the disease. This statement emphasizes the need to choose the correct treatment tactics, as well as to closely monitor the structural and functional characteristics of patients with glaucoma. In this regard, the issue of studying the safety and effectiveness of various glaucoma surgeries depending on observation time remains relevant. ","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132614488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.53432/2078-4104-2021-20-2-31-42
A. Kuroyedov, A. Movsisyan, E. Egorov, V. P. Erichev, V. V. Gorodnichy, A. Brezhnev, I. Gazizova
PURPOSE. To determine individual clinical and epidemiological characteristics of the disease in patients with primary openangle glaucoma (POAG) and to establish its relationship with adherence to treatment.METHODS. The analytical, multicenter, combined study involved 1 092 subjects (2 184 eyes) with different forms of glaucoma (general group) were selected using a survey, followed by their clinical and epidemiological analysis.RESULTS. When verifying the diagnosis, eyes with POAG prevailed in the main group (from 89.6 to 92% of all eyes). The average age in the main group at the final examination was 66 (63; 69) years, the duration of the disease was on average 3 years. The number of eyes with the initial stage of glaucoma decreased in 3 years by 17.5-19.1%, and the number of eyes with advanced and severe stages of the disease increased by 10.4-12.9% and 5.1-5.2%, respectively. The hypotensive regimen was changed at the average tonometric intraocular pressure of 24 (23; 26) mm Hg (regardless of the disease stage). When estimating the comorbidity of the main group, the most common concomitant somatic pathology was hypertension. Today, prostaglandin analogues are prescribed in 34.6-36.3% of all cases for all stages of glaucoma. The leading complaint of patients according to the survey was the cost of treatment. In addition, the influence of the organization's pharmacist on the choice of the purchased drug was revealed. However, attending physician remains the main source of information about the disease for patients (92.2%).CONCLUSION. It was found that POAG predictably prevails in Russia, and its diagnosis still comes with a delay. The causes of treatment failures should be recognized as late diagnosis, incorrect treatment of patients with newly diagnosed condition, and the same treatment regimens for paired eyes with different stages of POAG, as well as social and behavioral factors of patient compliance.
目的。目的:探讨原发性开角型青光眼(POAG)患者的个体临床和流行病学特征，并探讨其与治疗依从性的关系。采用问卷调查的方法，选取不同类型青光眼(普通组)患者1 092例(2 184只眼)进行分析性、多中心联合研究，并对其进行临床和流行病学分析。验证诊断时，POAG眼占主要组(占所有眼的89.6 ~ 92%)。主组期末考试平均年龄66岁(63岁;69岁，病程平均3年。青光眼初期眼数在3年内减少了17.5-19.1%，晚期眼数和重度眼数分别增加了10.4-12.9%和5.1-5.2%。在平均眼压为24 (23;26) mm Hg(与疾病分期无关)。当估计主要组的合并症时，最常见的伴随躯体病理是高血压。如今，34.6-36.3%的青光眼患者使用前列腺素类似物。根据调查，病人抱怨最多的是治疗费用。此外，还揭示了组织药剂师对购买药物选择的影响。然而，主治医生仍然是患者疾病信息的主要来源(92.2%)。研究发现，POAG在俄罗斯可以预见地普遍存在，其诊断仍然是延迟的。治疗失败的原因应认识到诊断较晚、新诊断患者治疗不正确、不同分期的成对眼治疗方案相同以及患者依从性的社会和行为因素。
{"title":"The profile of patients with primary open-angle glaucoma in the Russian Federation (preliminary results of a multicenter population-based study). Part 2","authors":"A. Kuroyedov, A. Movsisyan, E. Egorov, V. P. Erichev, V. V. Gorodnichy, A. Brezhnev, I. Gazizova","doi":"10.53432/2078-4104-2021-20-2-31-42","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-31-42","url":null,"abstract":"PURPOSE. To determine individual clinical and epidemiological characteristics of the disease in patients with primary openangle glaucoma (POAG) and to establish its relationship with adherence to treatment.METHODS. The analytical, multicenter, combined study involved 1 092 subjects (2 184 eyes) with different forms of glaucoma (general group) were selected using a survey, followed by their clinical and epidemiological analysis.RESULTS. When verifying the diagnosis, eyes with POAG prevailed in the main group (from 89.6 to 92% of all eyes). The average age in the main group at the final examination was 66 (63; 69) years, the duration of the disease was on average 3 years. The number of eyes with the initial stage of glaucoma decreased in 3 years by 17.5-19.1%, and the number of eyes with advanced and severe stages of the disease increased by 10.4-12.9% and 5.1-5.2%, respectively. The hypotensive regimen was changed at the average tonometric intraocular pressure of 24 (23; 26) mm Hg (regardless of the disease stage). When estimating the comorbidity of the main group, the most common concomitant somatic pathology was hypertension. Today, prostaglandin analogues are prescribed in 34.6-36.3% of all cases for all stages of glaucoma. The leading complaint of patients according to the survey was the cost of treatment. In addition, the influence of the organization's pharmacist on the choice of the purchased drug was revealed. However, attending physician remains the main source of information about the disease for patients (92.2%).CONCLUSION. It was found that POAG predictably prevails in Russia, and its diagnosis still comes with a delay. The causes of treatment failures should be recognized as late diagnosis, incorrect treatment of patients with newly diagnosed condition, and the same treatment regimens for paired eyes with different stages of POAG, as well as social and behavioral factors of patient compliance.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115705801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.53432/2078-4104-2021-20-2-72-80
Yu.I. Razhko, I. A. Glushnev, N. A. Rebenok, A. Kuroyedov, A. Brezhnev
One of the priority directions in the development of medical science is activities associated with patenting and licensing. The review analyzes the inventions of new treatment methods of various forms of glaucoma among patents issued in the last 7 years. The search for new approaches to treating the disease continues despite the numerous known methods. The article describes promising medical, laser, microinvasive, surgical and combined methods for the treatment of glaucoma from the 123 new patents issued in the Russian Federation. Novel innovations are presented with design schemes.The review will be useful to a wide audience. Young specialists can invent, patent, and license their own original method of glaucoma treatment. Surgeons can expand their routine by introducing new technical elements from different methods, testing its effectiveness and safety in everyday practice.
{"title":"Novel approaches to glaucoma treatment (review of patents)","authors":"Yu.I. Razhko, I. A. Glushnev, N. A. Rebenok, A. Kuroyedov, A. Brezhnev","doi":"10.53432/2078-4104-2021-20-2-72-80","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-72-80","url":null,"abstract":"One of the priority directions in the development of medical science is activities associated with patenting and licensing. The review analyzes the inventions of new treatment methods of various forms of glaucoma among patents issued in the last 7 years. The search for new approaches to treating the disease continues despite the numerous known methods. The article describes promising medical, laser, microinvasive, surgical and combined methods for the treatment of glaucoma from the 123 new patents issued in the Russian Federation. Novel innovations are presented with design schemes.The review will be useful to a wide audience. Young specialists can invent, patent, and license their own original method of glaucoma treatment. Surgeons can expand their routine by introducing new technical elements from different methods, testing its effectiveness and safety in everyday practice.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126080893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.53432/2078-4104-2021-20-2-44-50
B. Aznabaev, A. Sh. Zagidullina, A. Arslanova
PURPOSE. To study the structure and dynamics of the trends of glaucoma-related disability recorded from initial medico-social examinations of the adult population in the Republic of Bashkortostan during 2014–2019.METHODS. The study presents a retrospective comparative analysis of the official annual statistical data of the Federal State Institution "Main Bureau of Medical and Social Expertise in the Republic of Bashkortostan" recorded during the six-year period from 2014 to 2019 and assesses the glaucoma-related disability trends.RESULTS. In the Republic of Bashkortostan in 2014, the rate of reassessed disability due to glaucoma was 0.79 per 10 thousand population, in 2019 — 0.56. The share of young individuals reassessed as disabled in 2019 was 3.9%, middle aged — 11.8%, above working age — 84.3%. The share of patients with group I disability in 2019 was 40.6%, with group II disability — 33.6%, group III — 25.8%.CONCLUSION. Based on the results of the performed analysis, in the Republic of Bashkortostan from 2014 to 2019 there was a decrease in indicators of reassessed disability due to glaucoma from 0.79 in 2014 to 0.56 per 10 thousand people in 2019. Repeated medical and social examinations carried out during the specified period showed an increase in the share of young people (from 18 to 44 years old) by 1.1%, as well as patients with group I disability by 16.8%.
{"title":"Disability caused by glaucoma in the Republic of Bashkortostan in the years 2014–2019","authors":"B. Aznabaev, A. Sh. Zagidullina, A. Arslanova","doi":"10.53432/2078-4104-2021-20-2-44-50","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-44-50","url":null,"abstract":"PURPOSE. To study the structure and dynamics of the trends of glaucoma-related disability recorded from initial medico-social examinations of the adult population in the Republic of Bashkortostan during 2014–2019.METHODS. The study presents a retrospective comparative analysis of the official annual statistical data of the Federal State Institution \"Main Bureau of Medical and Social Expertise in the Republic of Bashkortostan\" recorded during the six-year period from 2014 to 2019 and assesses the glaucoma-related disability trends.RESULTS. In the Republic of Bashkortostan in 2014, the rate of reassessed disability due to glaucoma was 0.79 per 10 thousand population, in 2019 — 0.56. The share of young individuals reassessed as disabled in 2019 was 3.9%, middle aged — 11.8%, above working age — 84.3%. The share of patients with group I disability in 2019 was 40.6%, with group II disability — 33.6%, group III — 25.8%.CONCLUSION. Based on the results of the performed analysis, in the Republic of Bashkortostan from 2014 to 2019 there was a decrease in indicators of reassessed disability due to glaucoma from 0.79 in 2014 to 0.56 per 10 thousand people in 2019. Repeated medical and social examinations carried out during the specified period showed an increase in the share of young people (from 18 to 44 years old) by 1.1%, as well as patients with group I disability by 16.8%.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126471443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.25700/2078-4104-2021-20-2-51-56
T. Botabekova, V. Erichev, N. Aldasheva, A. Bulgakova, G. K. Hachatryan
PURPOSE. To assess the hypotensive effectiveness, frequency and nature of intra- and postoperative complications in patients with various clinical manifestations of refractory glaucoma.MATERIALS AND METHODS. The study included 196 patients (196 eyes) with various forms, stages and clinical manifestations of glaucoma. There were 142 patients with primary glaucoma, among them 120 with open-angle glaucoma and 22 with angle-closure glaucoma. Among the patients with primary glaucoma, 85 had pseudophakia (77 with openangle and 8 with angle-closure forms); 57 had a native lens (43 with open-angle and 14 with angle-closure forms of the disease). Secondary glaucoma was presented mainly by patients with neovascular (21) and postuveal (16) glaucoma. The intraocular pressure (IOP) level in the group as a whole ranged from 16 to 50 mm Hg (on average 30.1±2.6 mm Hg). In all presented cases of surgical intervention, the Glautex drainage was used, which is a bioresorbable composite biomaterial based on polylactic acid (polylactide) and polyethylene glycol (manufactured by “HiBiTech”, Russia). Standard methods of patient examination were used. RESULTS.In patients with POAG, the IOP averaged 13.7± 4.7 mm Hg one week after surgery and 16.1±3 mm Hg 12 months after surgery. The absolute success of the operation was noted in 71 patients with POAG (59.2%); the relative hypotensive effect — in 85.8%. In primary angle-closure glaucoma, the same indicators were 47.6 and 61.1%, respectively. In the group of patients with neovascular and postuveal glaucoma, the hypotensive effect was as expected lower and amounted to 42.8 and 50.0%, respectively. The restart of therapy at different periods of observation was done in 78.3%. Complications, their frequency and nature, noted by us in the operated patients, could be attributed to those typical for fistulizing operations in refractory glaucoma. The most common complication was ciliochoroidal detachment, which was seen in all groups, but percentage-wise was more common in patients with PACG, neovascular and postuveal glaucoma.CONCLUSION. Composite drainage based on polylactic acid (polylactide) and polyethylene glycol (glautex) is an effective and safe solution to the issue of surgical treatment of glaucoma. The antihypertensive effectiveness of the Glautex drainage implant depends on the severity of the glaucomatous process and the timeliness of the surgical intervention. The frequency and nature of complications depends on the degree of refractoriness of glaucoma, initial clinical characteristics of the process, and patients' multimorbidity.
目的。评价不同临床表现的难治性青光眼患者的降压效果、术中术后并发症的发生频率和性质。材料和方法。本研究共纳入196例(196只眼)不同形式、分期和临床表现的青光眼患者。原发性青光眼142例，其中开角型青光眼120例，闭角型青光眼22例。原发性青光眼85例为假性晶状体，其中开角型77例，闭角型8例;57例有先天性晶状体(43例为开角型，14例为闭角型)。继发性青光眼主要见于新生血管性青光眼(21例)和眼后青光眼(16例)。整个组的眼压(IOP)水平在16 ~ 50 mm Hg之间(平均30.1±2.6 mm Hg)。在所有手术干预病例中，都使用了Glautex引流液，这是一种基于聚乳酸(聚乳酸)和聚乙二醇(由俄罗斯“HiBiTech”制造)的生物可吸收复合生物材料。采用标准的患者检查方法。结果。POAG患者术后一周眼压平均为13.7±4.7 mm Hg，术后12个月眼压平均为16.1±3 mm Hg。71例POAG患者手术绝对成功(59.2%);相对降压效果为85.8%。原发性闭角型青光眼的相同指标分别为47.6%和61.1%。在新生血管性青光眼和眼后青光眼组中，降压效果如预期的那样较低，分别为42.8%和50.0%。78.3%的患者在不同的观察时期重新开始治疗。我们在手术患者中注意到的并发症，其频率和性质，可归因于难治性青光眼的典型瘘手术。最常见的并发症是纤毛脉络膜脱离，这在所有组中都有发生，但在PACG、新生血管性青光眼和眼后青光眼中更常见。以聚乳酸(聚乳酸)和聚乙二醇(青光眼)为基础的复合引流术是解决青光眼手术治疗问题的有效、安全的方法。青光眼引流植入物的降压效果取决于青光眼过程的严重程度和手术干预的及时性。并发症的发生频率和性质取决于青光眼的难治性程度、病程的初始临床特征和患者的多发病情况。
{"title":"Composite drainage in glaucoma surgery","authors":"T. Botabekova, V. Erichev, N. Aldasheva, A. Bulgakova, G. K. Hachatryan","doi":"10.25700/2078-4104-2021-20-2-51-56","DOIUrl":"https://doi.org/10.25700/2078-4104-2021-20-2-51-56","url":null,"abstract":"PURPOSE. To assess the hypotensive effectiveness, frequency and nature of intra- and postoperative complications in patients with various clinical manifestations of refractory glaucoma.MATERIALS AND METHODS. The study included 196 patients (196 eyes) with various forms, stages and clinical manifestations of glaucoma. There were 142 patients with primary glaucoma, among them 120 with open-angle glaucoma and 22 with angle-closure glaucoma. Among the patients with primary glaucoma, 85 had pseudophakia (77 with openangle and 8 with angle-closure forms); 57 had a native lens (43 with open-angle and 14 with angle-closure forms of the disease). Secondary glaucoma was presented mainly by patients with neovascular (21) and postuveal (16) glaucoma. The intraocular pressure (IOP) level in the group as a whole ranged from 16 to 50 mm Hg (on average 30.1±2.6 mm Hg). In all presented cases of surgical intervention, the Glautex drainage was used, which is a bioresorbable composite biomaterial based on polylactic acid (polylactide) and polyethylene glycol (manufactured by “HiBiTech”, Russia). Standard methods of patient examination were used. RESULTS.In patients with POAG, the IOP averaged 13.7± 4.7 mm Hg one week after surgery and 16.1±3 mm Hg 12 months after surgery. The absolute success of the operation was noted in 71 patients with POAG (59.2%); the relative hypotensive effect — in 85.8%. In primary angle-closure glaucoma, the same indicators were 47.6 and 61.1%, respectively. In the group of patients with neovascular and postuveal glaucoma, the hypotensive effect was as expected lower and amounted to 42.8 and 50.0%, respectively. The restart of therapy at different periods of observation was done in 78.3%. Complications, their frequency and nature, noted by us in the operated patients, could be attributed to those typical for fistulizing operations in refractory glaucoma. The most common complication was ciliochoroidal detachment, which was seen in all groups, but percentage-wise was more common in patients with PACG, neovascular and postuveal glaucoma.CONCLUSION. Composite drainage based on polylactic acid (polylactide) and polyethylene glycol (glautex) is an effective and safe solution to the issue of surgical treatment of glaucoma. The antihypertensive effectiveness of the Glautex drainage implant depends on the severity of the glaucomatous process and the timeliness of the surgical intervention. The frequency and nature of complications depends on the degree of refractoriness of glaucoma, initial clinical characteristics of the process, and patients' multimorbidity.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"5 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116858672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-10DOI: 10.53432/2078-4104-2021-20-2-23-29
L. P. Dogadova, E. V. Girenok, E. Markelova, V. Melnikov
PURPOSE. To conduct a descriptive epidemiological study of glaucoma in the Far Eastern Federal District covering the years 2012 to 2019.METHODS. The study uses data of the Federal Research Institute for Health Organization and Informatics (FRIHOI) covering the 2012–2019 time period, as well as data from the register of the Unified Interdepartmental Information and Statistical System (UIISS) and the Federal State Statistics Service (FSSS). Statistical data processing was carried out using Microsoft Excel 2019. Diagrams and a cartogram were built to visualize the obtained data. The reliability of the trend line was determined by the value of approximation. A trend is a tendency of changes in the studied time series. In this work, we used a linear approximation — a straight line that best describes the time course of incidence and prevalence. The significance of linear regression was checked using the F-test to determine the quality of the regression model. The coefficient of determination was also used to indicate the dependence of the variability of prevalence on time. A linear regression model was used to predict the prevalence of glaucoma in the Russian Federation and the Far Eastern Federal District; 91% of the total variability of prevalence in the Russian Federation is explained by a change in the time parameter, while 86% in the Far Eastern Federal District indicates a high accuracy of the selection of trend equations.RESULTS. According to the study, in the 2012–2019 years there was a significant increase in the incidence of glaucoma in the Primorsky Krai (PK) amounting to 8%. Over the observed period, a significant increase in the prevalence of glaucoma is noted in the Republic of Buryatia (6.9%), and in the Magadan Region (5%). At the same time, the highest incidence and prevalence of glaucoma was noted in the Republic of Sakha (Yakutia) — 105.4 cases and 1551.6 cases per 100 000 population. The expected prevalence of glaucoma in the Russian Federation (RF) in 2020 is 895–999.7 per 100 000 population, in 2021 — 908–1020.2; in the Far Eastern Federal District (FEFD) in 2020 — 783.7–961.3 per 100 000 population, in 2021 — 799.5–989.8. The largest proportion of glaucoma was found among the population of the Magadan Region (16%) and Yakutia (13.8%), the smallest in the Amur Region (5%) and the Chukotka Autonomous Okrug (5.7%).CONCLUSION. The dynamics of glaucoma incidence in the Far Eastern Federal District is uneven, which corresponds to the epidemiological situation in the Russian Federation as a whole. But the prevalence and proportion of glaucoma in the structure of diseases of the eye and adnexa in the FEFD are characterized by negative dynamics in comparison with country-wide. At the same time, even within the regions of the FEFD, the incidence and prevalence of glaucoma is mosaic, which predisposes to studying the influence of factors on glaucoma incidence.
{"title":"Descriptive epidemiological study of glaucoma in the Far Eastern Federal District covering the years 2012 to 2019","authors":"L. P. Dogadova, E. V. Girenok, E. Markelova, V. Melnikov","doi":"10.53432/2078-4104-2021-20-2-23-29","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-23-29","url":null,"abstract":"PURPOSE. To conduct a descriptive epidemiological study of glaucoma in the Far Eastern Federal District covering the years 2012 to 2019.METHODS. The study uses data of the Federal Research Institute for Health Organization and Informatics (FRIHOI) covering the 2012–2019 time period, as well as data from the register of the Unified Interdepartmental Information and Statistical System (UIISS) and the Federal State Statistics Service (FSSS). Statistical data processing was carried out using Microsoft Excel 2019. Diagrams and a cartogram were built to visualize the obtained data. The reliability of the trend line was determined by the value of approximation. A trend is a tendency of changes in the studied time series. In this work, we used a linear approximation — a straight line that best describes the time course of incidence and prevalence. The significance of linear regression was checked using the F-test to determine the quality of the regression model. The coefficient of determination was also used to indicate the dependence of the variability of prevalence on time. A linear regression model was used to predict the prevalence of glaucoma in the Russian Federation and the Far Eastern Federal District; 91% of the total variability of prevalence in the Russian Federation is explained by a change in the time parameter, while 86% in the Far Eastern Federal District indicates a high accuracy of the selection of trend equations.RESULTS. According to the study, in the 2012–2019 years there was a significant increase in the incidence of glaucoma in the Primorsky Krai (PK) amounting to 8%. Over the observed period, a significant increase in the prevalence of glaucoma is noted in the Republic of Buryatia (6.9%), and in the Magadan Region (5%). At the same time, the highest incidence and prevalence of glaucoma was noted in the Republic of Sakha (Yakutia) — 105.4 cases and 1551.6 cases per 100 000 population. The expected prevalence of glaucoma in the Russian Federation (RF) in 2020 is 895–999.7 per 100 000 population, in 2021 — 908–1020.2; in the Far Eastern Federal District (FEFD) in 2020 — 783.7–961.3 per 100 000 population, in 2021 — 799.5–989.8. The largest proportion of glaucoma was found among the population of the Magadan Region (16%) and Yakutia (13.8%), the smallest in the Amur Region (5%) and the Chukotka Autonomous Okrug (5.7%).CONCLUSION. The dynamics of glaucoma incidence in the Far Eastern Federal District is uneven, which corresponds to the epidemiological situation in the Russian Federation as a whole. But the prevalence and proportion of glaucoma in the structure of diseases of the eye and adnexa in the FEFD are characterized by negative dynamics in comparison with country-wide. At the same time, even within the regions of the FEFD, the incidence and prevalence of glaucoma is mosaic, which predisposes to studying the influence of factors on glaucoma incidence.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117298561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-09DOI: 10.53432/2078-4104-2021-20-2-14-22
V. Erichev, R. P. Poleva, Kh. Hadiri
INTRODUCTION. Recently, posterior vitreous detachment (PVD) was suggested as a fundamental pathologic process in primary angle-closure glaucoma (PACG) in morphologically predisposed patients with anatomically narrow anterior chamber angle.PURPOSE. To study the role of PVD in the development and clinical manifestation of PACG in anatomically predisposed eyes and to assess the capabilities of posterior segment optical coherence tomography (PS-OCT) in PACG diagnostics.MATERIALS AND METHODS. Thirty eyes with newly diagnosed stage I-II PACG and thirty eyes predisposed to PACG (with narrow anterior chamber angle without glaucoma signs) were enrolled in the study. All patients underwent ophthalmological examination, Hyams test, ocular ultrasound (OU) and PS-OCT.RESULTS. PVD with retrohyaloid space (RHS) formation was revealed in all PACG eyes. Positive Hyams test was in 86.67% eyes with PACG, and 13.33% were negative. All the eyes with PVD as a result of Hyams test experienced RHS enhancement correlating with IOP rise. Despite the negative results of Hyams test in some PACG eyes with PVD — glaucomatous optic neuropathy signs were present. Possible causes are discussed.PVD with RHS formation was revealed in 53.33% predisposed to PACG eyes — all with positive result of Hyams test. The other 46.67% eyes predisposed to PACG had negative Hyams test, no PVD and no RHS.CONCLUSION. Obtained results confirm a new theory of PACG etiopathogenesis suggesting PVD with PGS to be the essential mechanism of POAG development in morphologically predisposed eyes. PS-OCT appears to be crucial in PACG early diagnostics.
{"title":"New capabilities of optical coherence tomography in the diagnostics of primary angle-closure glaucoma","authors":"V. Erichev, R. P. Poleva, Kh. Hadiri","doi":"10.53432/2078-4104-2021-20-2-14-22","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-14-22","url":null,"abstract":"INTRODUCTION. Recently, posterior vitreous detachment (PVD) was suggested as a fundamental pathologic process in primary angle-closure glaucoma (PACG) in morphologically predisposed patients with anatomically narrow anterior chamber angle.PURPOSE. To study the role of PVD in the development and clinical manifestation of PACG in anatomically predisposed eyes and to assess the capabilities of posterior segment optical coherence tomography (PS-OCT) in PACG diagnostics.MATERIALS AND METHODS. Thirty eyes with newly diagnosed stage I-II PACG and thirty eyes predisposed to PACG (with narrow anterior chamber angle without glaucoma signs) were enrolled in the study. All patients underwent ophthalmological examination, Hyams test, ocular ultrasound (OU) and PS-OCT.RESULTS. PVD with retrohyaloid space (RHS) formation was revealed in all PACG eyes. Positive Hyams test was in 86.67% eyes with PACG, and 13.33% were negative. All the eyes with PVD as a result of Hyams test experienced RHS enhancement correlating with IOP rise. Despite the negative results of Hyams test in some PACG eyes with PVD — glaucomatous optic neuropathy signs were present. Possible causes are discussed.PVD with RHS formation was revealed in 53.33% predisposed to PACG eyes — all with positive result of Hyams test. The other 46.67% eyes predisposed to PACG had negative Hyams test, no PVD and no RHS.CONCLUSION. Obtained results confirm a new theory of PACG etiopathogenesis suggesting PVD with PGS to be the essential mechanism of POAG development in morphologically predisposed eyes. PS-OCT appears to be crucial in PACG early diagnostics.","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"370 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122852519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-09DOI: 10.53432/2078-4104-2021-20-2-3-13
N. Volkova, A. Shchuko, T. Iureva
PURPOSE.To identify the relationship between the parameters of choroidal and retinal blood flow by optical coherence tomography (OCT) and OCT angiography (OCT-A), and the structural, hydrodynamic and systemic hemodynamic parameters in healthy adults.METHODS.The study included 42 male subjects aged 54.43±4.1 years without signs of local or systemic pathologies. The following parameters were evaluated on the RTVue-XR tomograph (USA): structural and microcirculatory parameters of the optic disc (OD) — peripapillary retinal nerve fiber layer (pRLNF) and radial peripapillary capillary plexus (RPCP); the macula — thickness, superficial capillary plexus (SCP), deep vascular complex (DVC), foveolar avascular zone (FAZ); the choroid — thickness, structure. Blood pressure was determined using the Riva–Rocci method; tonometry — by the Maklakov method. The parameters of bidirectional corneal applanation were evaluated, and perfusion and tolerance pressure were calculated.RESULTS.Negative correlations were revealed between intraocular pressure, pRNFL and capillary density of RCP (R= −0.58… −0.73); between choroid thickness, systemic blood flow, and tolerant pressure (R= −0.56… −0.72); between the thickness of the choroid and the volume of focal losses (FLV, %), as well as the OCT-A parameters of FAZ (area, perimeter, and density of foveolar vessels) (R= −0.45… −0.58). Positive correlations were found between perifoveal thickness (including ganglion complex) with the pRNFL (R=0.58–0.71), as well as with the thickness of the choroid (R=0.41–0.65). The confidence level was p≤0.001.CONCLUSION. The relationship of retinal, choroidal, micro hemodynamics parameters by OCT (choroid thickness) and OCT-A (RCC) (HD Angio Disc 4.5 protocol); area, perimeter, and vascular density of FAZ (Angio Retina 3.0 protocol) with the parameters of systemic blood flow in healthy subjects can likely be considered as hemodynamic biomarkers in the diagnosis, monitoring, and evaluation of treatment effectiveness of any intraocular vascular process (including glaucoma).
{"title":"OCT and OCT-angiography parameters of intraocular blood flow in healthy adults","authors":"N. Volkova, A. Shchuko, T. Iureva","doi":"10.53432/2078-4104-2021-20-2-3-13","DOIUrl":"https://doi.org/10.53432/2078-4104-2021-20-2-3-13","url":null,"abstract":"PURPOSE.To identify the relationship between the parameters of choroidal and retinal blood flow by optical coherence tomography (OCT) and OCT angiography (OCT-A), and the structural, hydrodynamic and systemic hemodynamic parameters in healthy adults.METHODS.The study included 42 male subjects aged 54.43±4.1 years without signs of local or systemic pathologies. The following parameters were evaluated on the RTVue-XR tomograph (USA): structural and microcirculatory parameters of the optic disc (OD) — peripapillary retinal nerve fiber layer (pRLNF) and radial peripapillary capillary plexus (RPCP); the macula — thickness, superficial capillary plexus (SCP), deep vascular complex (DVC), foveolar avascular zone (FAZ); the choroid — thickness, structure. Blood pressure was determined using the Riva–Rocci method; tonometry — by the Maklakov method. The parameters of bidirectional corneal applanation were evaluated, and perfusion and tolerance pressure were calculated.RESULTS.Negative correlations were revealed between intraocular pressure, pRNFL and capillary density of RCP (R= −0.58… −0.73); between choroid thickness, systemic blood flow, and tolerant pressure (R= −0.56… −0.72); between the thickness of the choroid and the volume of focal losses (FLV, %), as well as the OCT-A parameters of FAZ (area, perimeter, and density of foveolar vessels) (R= −0.45… −0.58). Positive correlations were found between perifoveal thickness (including ganglion complex) with the pRNFL (R=0.58–0.71), as well as with the thickness of the choroid (R=0.41–0.65). The confidence level was p≤0.001.CONCLUSION. The relationship of retinal, choroidal, micro hemodynamics parameters by OCT (choroid thickness) and OCT-A (RCC) (HD Angio Disc 4.5 protocol); area, perimeter, and vascular density of FAZ (Angio Retina 3.0 protocol) with the parameters of systemic blood flow in healthy subjects can likely be considered as hemodynamic biomarkers in the diagnosis, monitoring, and evaluation of treatment effectiveness of any intraocular vascular process (including glaucoma).","PeriodicalId":129515,"journal":{"name":"National Journal glaucoma","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116269128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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