New technologies in primary open-angle glaucoma diagnostics

PURPOSE: To determine the most important diagnostic criteria to distinguish the preperimetric glaucoma from the perimetric stage using complex analysis of structural, functional and ocular blood flow parameters. METHODS: 90 eyes, including 30 eyes with preperimetric glaucoma, 30 eyes with perimetric glaucoma and 30 normal eyes, were analyzed. The average thickness of the GCC, retinal nerve fiber layer thickness (avg. RNFLT) and choroidal thickness were measured using RTVue spectral-domain optical coherence tomography (SD-OCT). Perimetry - using Humphrey test («Carl Zeiss Meditec», Dublin, CA). Ocular blood flow velocity was measured by the color Doppler mapping («VOLUSON 730 ProSystem»). Intraocular pressure (lOPcc) and corneal hysteresis (CH) were determined using «Ocular Response Analyzer» (ORA). Standardized statistics (Z-value) of Wilcoxon - MannWhitney rank sum test and the area (S-ROC) under the receiver operating characteristic curve for logistic regression model was used to determine the most important diagnostic criteria in glaucoma. RESULTS: The difference between perimetric and preperimetric glaucoma could be characterized by 5 important diagnostic criteria: avg. RNFLT (S-ROC 0.93; z-value 5.75), PSD (0.91; -5.52), peripapillar choroidal thickness (0.7; 2.69), the end diastolic blood flow velocity in the medial posterior ciliary arteries (0.7; 2.55) and corneal hysteresis (0.68; 2.41). CONCLUSIONS: Five clinical parameters have been determined as the most important to distinguish the preperimetric glaucoma from the perimetric stage: avg. RNFLT, PSD, peripapillar choroidal thickness, the end diastolic blood flow velocity in the medial posterior ciliary arteries and corneal hysteresis. This data should be considered in glaucoma monitoring.

первичная открытоугольная глаукома, RNFL, GCC, оптическая когерентная томография, PSD, толщина хориоидеи, глазной кровоток, primary open-angle glaucoma, RNFL, GCC, optical coherence tomography, PSD, choroidal thickness, ocular blood flow

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