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Complex spectrofluorimetric assessment of limbal ischemia in patients with primary glaucoma during treatment with prostaglandin analogues

https://doi.org/10.53432/2078-4104-2023-22-4-15-25

Abstract

PURPOSE. Comparative assessment of the spectrofluorimetric parameters of the limbus area in patients with primary open-angle glaucoma (POAG) receiving various molecules of prostaglandin analogues topically.

METHODS. The study included 129 patients (129 eyes) with newly diagnosed primary open-angle glaucoma who were randomized into four groups depending on the prostaglandin analogue they used for one month. The control group consisted of patients who were prescribed a non-selective beta-blocker (timolol). Patients underwent a comprehensive ophthalmological examination and spectrofluorimetric study of the limbus area.

RESULTS. In all studied groups, the achieved hypotensive effect after one month of instillations was 30.6–34.5% of the baseline intraocular pressure (IOP) level. Stabilization of glaucomatous optic neuropathy was determined in all study groups regardless of the stage of POAG with varying degrees of significance. The most pronounced ischemic effect on the limbus area was recorded in patients with moderate POAG using travoprost (increase in fluorescence intensity of 0.14; p=0.018), advanced POAG — using bimatoprost (increase in fluorescence intensity of 0.141; p<0.0001). Latanoprost had a lesser effect on ischemia of the limbal area — increase in fluorescence intensity of 0.124 (p=0.043) and 0.104 (p<0.001) in moderate and advanced stages, respectively. In the control group in all examined patients the difference in fluorescence indices was insignificant, which may indicate a minimal effect of timolol on ischemia of the limbus area.

CONCLUSION. Spectrofluorometric indicators of the limbal area reflect the ischemic effect of all molecules within the prostaglandin analogue class, while the use of beta-blockers causes a minimal effect on ischemia. The use of any prostaglandin analogues in patients with advanced POAG leads to more pronounced ischemia of the limbal area than in eyes with moderate stage, which suggests a greater tendency to scarring of the filtering bleb after hypotensive interventions.

About the Authors

V. V. Garkavenko
Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov
Russian Federation

Cand. Sci. (Med.), Head of Department

1c Nikitina St., Krasnoyarsk, 660022



P. M. Balashova
Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov; Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
Russian Federation

ophthalmologist, Krasnoyarsk Regional Ophthalmological Clinical Hospital named after Professor P.G. Makarov; Assistant at the Academic Department of Ophthalmology named after Professor M.A. Dmitriev with postgraduate education courses, Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky

1c Nikitina St., Krasnoyarsk, 660022

1 Partizana Zheleznyaka St., Krasnoyarsk, 660022



L. A. Shapiro
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
Russian Federation

Assistant at the Academic Department of Medical and Biological Physics

1 Partizana Zheleznyaka St., Krasnoyarsk, 660022



V. V. Salmin
National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)
Russian Federation

Dr. Sci. (Phys.-Math.), Professor at the Academic Department of Laser Micro-, Nano- and Biotechnologies

31 Kashirskoe highway, Moscow, 115409



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Review

For citations:


Garkavenko V.V., Balashova P.M., Shapiro L.A., Salmin V.V. Complex spectrofluorimetric assessment of limbal ischemia in patients with primary glaucoma during treatment with prostaglandin analogues. National Journal glaucoma. 2023;22(4):15-25. (In Russ.) https://doi.org/10.53432/2078-4104-2023-22-4-15-25

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ISSN 2078-4104 (Print)
ISSN 2311-6862 (Online)