glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2025-24-3-44-51glaucoma-584Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКлинические особенности некоторых офтальмологических состояний в условиях хронологической коморбидностиClinical features of certain ophthalmological conditions in the context of chronological comorbidityhttps://orcid.org/0000-0002-9833-6236ФроловМ. А.FrolovM. A.

д.м.н., профессор, заведующий кафедрой глазных болезней, директор офтальмологического центра

117198, Москва, ул. Миклухо-Маклая, 6

117198, Москва, ул. Миклухо-Маклая, 10

Dr. Sci. (Med.), Professor, Head of the Academic Department of Eye Diseases, Director of the Ophthalmology Center

6 Miklukho-Maklaya St., Moscow, 117198

10 Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0003-2707-8417ВоробьеваИ. В.VorobyevaI. V.

д.м.н., профессор, профессор кафедры глазных болезней, врач-офтальмолог 

117198, Москва, ул. Миклухо-Маклая, 6

117198, Москва, ул. Миклухо-Маклая, 10

Dr. Sci. (Med.), Professor, Professor at the Academic Department of Eye Diseases, ophthalmologist

6 Miklukho-Maklaya St., Moscow, 117198

10 Miklukho-Maklaya St., Moscow, 117198

vorobyeva_iv@pfur.ruhttps://orcid.org/0000-0003-0988-1361ФроловА. М.FrolovA. M.

к.м.н., доцент кафедры глазных болезней, врач-офтальмолог 

117198, Москва, ул. Миклухо-Маклая, 6

117198, Москва, ул. Миклухо-Маклая, 10

Cand. Sci. (Med.), Associate Professor at the Academic Department of Eye Diseases, ophthalmologist

6 Miklukho-Maklaya St., Moscow, 117198

10 Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0003-3576-293XШаллахСамиShallahSami

аспирант третьего года обучения кафедры глазных болезней

117198, Москва, ул. Миклухо-Маклая, 6

postgraduate student at the Academic Department of Eye Diseases 

6 Miklukho-Maklaya St., Moscow, 117198

СеминаД. А.SeminaD. A.

ассистент кафедры глазных болезней, врач-офтальмолог 

117198, Москва, ул. Миклухо-Маклая, 6

117198, Москва, ул. Миклухо-Маклая, 10

Assistant at the Academic Department of Eye Diseases; ophthalmologist 

6 Miklukho-Maklaya St., Moscow, 117198

10 Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0009-0009-4659-8988СабихЭванSabihEvan

ординатор второго года обучения кафедры глазных болезней 

117198, Москва, ул. Миклухо-Маклая, 6

resident physician at the Academic Department of Eye Diseases 

6 Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0009-0001-7543-1185МаалаКаррар ХайдерMaalaKarrar Haider

ординатор первого года обучения кафедры глазных болезней 

117198, Москва, ул. Миклухо-Маклая, 6

resident physician at the Academic Department of Eye Diseases 

6 Miklukho-Maklaya St., Moscow, 117198

https://orcid.org/0000-0001-8591-3746КлименкоА. С.KlimenkoA. S.

к.м.н, доцент аккредитационно-симуляционного центра Медицинского института; директор

117198, Москва, ул. Миклухо-Маклая, 6

117198, Москва, ул. Миклухо-Маклая, 10

Cand. Sci. (Med.), Associate Professor at the Accreditation-Simulation Center of the Medical Institute; Director of the Clinical and Diagnostic Center

6 Miklukho-Maklaya St., Moscow, 117198

10 Miklukho-Maklaya St., Moscow, 117198

ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы» ; Клинико-диагностический центр ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»РоссияPatrice Lumumba Peoples' Friendship University of Russia ; Ophthalmology Center of the Clinical Diagnostic Center, Patrice Lumumba Peoples' Friendship University of RussiaRussian FederationФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»РоссияPatrice Lumumba Peoples' Friendship University of RussiaRussian Federation2025130920252434451Copyright © Фролов М.А., Воробьева И.В., Фролов А.М., Шаллах С., Семина Д.А., Сабих Э., Маала К., Клименко А.С., 20252025Фролов М.А., Воробьева И.В., Фролов А.М., Шаллах С., Семина Д.А., Сабих Э., Маала К., Клименко А.С.Frolov M.A., Vorobyeva I.V., Frolov A.M., Shallah S., Semina D.A., Sabih E., Maala K., Klimenko A.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/584

ЦЕЛЬ. Мониторинг пациентов с сахарным диабетом II типа (СД2) с возрастной макулярной дегенерацией (ВМД), возникшей после перенесенного COVID-19.МЕТОДЫ. В основную группу вошли 29 пациентов с СД2 и ВМД в поздней стадии (AREDS IV), возникшей после перенесенного COVID-19. Контрольную группу составили данные 22 здоровых человек. Выполнили стандартное офтальмологическое исследование, оптическую когерентную томографию, оценку С-реактивного белка (СРБ), D-димера, гликированного гемоглобина (HbA1c).РЕЗУЛЬТАТЫ. Центральная толщина сетчатки (ЦТС) коррелирует с уровнем гликированного гемоглобина (r=0,80; p<0,05) и с уровнем С-реактивного белка (r=0,43; p<0,05). Средние значения ЦТС — 274,3±3,1 мкм, максимальной корригированной остроты зрения — 0,03±0,01, СРБ — 40,03±2,00 мг/л, D-димера — 150±3,0 нг/мл, уровень HbA1c — 10,6±0,2%. У пациентов, находящихся под наблюдением, при высоком уровне С-реактивного белка и D-димера зрительные функции в пределах 0,01…0,09, внутриглазное давление в пределах нормы. При положительной динамике ЦТС снижается. Приведен клинический случай пациента с ВМД, хориоидальной неоваскуляризацией с переходом в рубцовую форму, непролиферативной диабетической ретинопатией, открытоугольной глаукомой IIIА, состоянием после частичного гемофтальма и субретинального кровоизлияния на фоне перенесенного COVID-19. Гипотензивный режим: фиксированная комбинация биматопроста 0,3 мг/мл и тимолола 5 мг/мл (Бимокко-СЗ), дорзоламид (Дорзоламид-СЗ), бримонидин (Бримонидин-СЗ; все препараты — НАО «Северная звезда», РФ).ЗАКЛЮЧЕНИЕ. Пациенты с СД2 с ВМД, возникшей после перенесенного COVID-19 с тяжелой потерей зрения и с высокими биохимическими маркерами воспаления и тромбообразования требуют динамического наблюдения и междисциплинарного подхода.

PURPOSE. To monitor patients with type 2 diabetes mellitus who developed age-related macular degeneration (AMD) following a COVID-19 infection.METHODS. The study included 58 patients who underwent a comprehensive examination, they were equally divided into two groups. The main group consisted of 29 patients with type 2 diabetes mellitus and late-stage age-related macular degeneration (AREDS IV) that developed following a COVID-19 infection. In the control group of 29 patients, 12 (41%) had no history of ocular diseases prior to COVID-19, while 17 (59%) had been diagnosed with the dry form of AMD (AREDS I) before the infection.RESULTS. Central retinal thickness (CRT) correlated with the level of glycated hemoglobin (r=0.80; p<0.05) and C-reactive protein (r=0.43; p<0.05). The mean CRT was 274.3±3.1 μm; best corrected visual acuity (BCVA) — 0.03±0.01; C-reactive protein — 40.03±2.00 mg/L; D-dimer — 150±3.0 ng/mL; and glycated hemoglobin (HbA1c) — 10.6±0.2%. Among study patients, those with elevated levels of C-reactive protein and D-dimer had visual acuity ranging from 0.01 to 0.09, while intraocular pressure remained within normal limits. A favorable trend was associated with a decrease in CRT. The article also presents a clinical case of a patient with AMD, choroidal neovascularization evolving into a fibrotic form, nonproliferative diabetic retinopathy, stage IIIА open-angle glaucoma, a history of partial vitreous hemorrhage, and subretinal bleeding following COVID-19 infection. The hypotensive regimen included a fixed combination of bimatoprost 0.3 mg/mL and timolol 5 mg/mL (Bimokko-SZ), dorzolamide (Dorzolamide-SZ), and brimonidine (Brimonidine-SZ; all medications manufactured by NAO Severnaya Zvezda, Russia).CONCLUSION. Patients with type 2 diabetes and AMD that developed after COVID-19, accompanied by severe vision loss and elevated biochemical markers of inflammation and thrombogenesis, require regular follow-up and an interdisciplinary approach.

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The authors declare that there are no conflicts of interest present.