The structural-functional and hemodynamic features in patients with simple and pseudoexfoliative open-angle glaucoma and ophthalmic hypertension in a model of glaucoma development prognosis. Part 3

OBJECTIVE: To develop the probability model of glaucoma development based on the characteristics of regional hemodynamics, clinical, structural and functional characteristics of the eye globe with simple primary and pseudoexfoliative open-angle glaucoma (PEG, POAG) and ocular hypertension (OH).

METHODS:The work was carried out in the period from 2011 to July 2017, the data of analytical, observational case-control studies was analyzed. According to inclusion and non-inclusion criteria, out of 1370 patients under our observation we picked 290 patients (540 eyes) with POAG, PEG and OH, as well as healthy people for control. Among the examined patients there were 243 (83%) women and 47 (17%) men. 140 (25.9%) eyes of patients diagnosed with POAG and aged 69.7±9.0 years (64.1-76.1) comprised the first group of patients. PEG was detected in 104 (19.2%) eyes (age — 70.2 (67.1; 76.6); 71.2±6.6 years) were included into the 2nd group of patients. Ocular hypertension was established in 116 eyes (21.5%) (age — 64.3 (60.1; 686); 64.3±8.4 year) — the third group of patients. The fourth group (control) included healthy people, 125 (23.1%) eyes (age — 63.6 (58.7; 68.6); 63.7±8.3 years). In a separate group of unilateral PEG, contralateral eyes were diagnosed with one-sided PEG — a total of 55 eyes (10.3%) (age — 69.6 (65.4; 75.0); 70.2±7.3 years).

RESULTS: Based on the obtained structural and functional data, and data from regional hemodynamics, a regression model was constructed that predicted the development of glaucoma.

CONCLUSION: Сonvincing data of the difference in the characteristics of regional hemodynamics were obtained depending on the diagnosis, in the following vessels: OA, CRA, choroid from the temporal side. At the same time, the blood flow velocity in the CRA and the choroid in conditions that threaten the development of glaucoma OG 

and unilateral PEG can act as a predictor of the transition from a healthy state to a glaucoma state and be regarded as a compensatory mechanism that prevents the development of glaucoma. Inclusion of regional hemodynamics
in the glaucoma prediction model allows diagnosing glaucoma with high accuracy (sensitivity and specificity up to 83.8%). The created probability calculator glaucoma allows you to diagnose glaucoma with an accuracy of 79.9%.

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