PURPOSE: To analyze accompanying pathology in primary open-angle glaucoma patients of different age groups.
METHODS: The analysis covered 1098 out-patient cards of patients with all stages of POAG, who received treatment in glaucoma unit of the Altai regional ophthalmologic hospital from 2013 to 2015. The patients were divided into 3 age groups: Group I included 312 middle aged patients (45-59 years), Group II comprised 492 patients of advanced age (60-74 years), Group III — 294 senile patients (≥75 years).
RESULTS: Based on the analysis of the accompanying pathology we were able to sum up a glaucoma patient’s «portrait». Thus, a middle aged patient had a 1.5 ophthalmologic pathology comorbidity index: with 37.5% patients manifesting with cataracts, 18.0% — with dry eye syndrome and 8.7% — with chronic conjunctival diseases; a 1.7 somatic pathology comorbidity index: in 36.9% cases patients presented with arterial hypertension, in 16.3% — with a thyroid gland disease, in 14.1% — with diseases of the alimentary system. An advanced age patient had a 1.9 ophthalmologic pathology comorbidity index and a 2.3 somatic pathology comorbidity index. Accompanying eye conditions included cataract (48.0%), dry eye syndrome (28.7%), a history of cataract surgery (26.8%) and chronic conjunctival diseases (15.9%); somatic pathology comprised: arterial hypertension (53.9%), coronary heart disease (28.0%), COPD (21.1%), discirculatory encephalopathy (17.3%). A senile patient presented with 2.4 and 3.4 comorbidity indices for ophthalmologic and somatic pathology correspondingly: 62.9% — cataracts, 48.0% — dry eye syndrome, 36.7% — artiphakia, 21.1% — chronic conjunctival diseases; 34.7% — arterial hypertension, 24.5% — COPD and 25.9% — discirculatory encephalopathy.
CONCLUSION: Both ophthalmologic and somatic pathology comorbidity indices increase significantly with age. There are differences in accompanying pathology prevalence between patients of middle and advanced age, and between patients of advanced and senile age. Increase in occurrence of lens diseases, dry eye syndrome, pathologies of cardiovascular, respiratory and nervous systems had a direct correlation with age. Metaboliс disorders such as obesity and gastointestinal tract diseases on the other hand decreased with age. Cataract, dry eye syndrome, arterial hypertension, coronary heart disease, discirculatory encephalopathy may be considered syntropic for glaucoma.

PURPOSE: To assess hypotensive efficiency and conduct a compositional analysis of different samples of generic latanoprost 0,005% (Prolatan, “Sentiss Rus”, India) in combined treatment of primary open-angle glaucoma (POAG) patients.
METHODS: The study included patients with different stages of POAG. Initially, patients received a separate combination therapy that included beta-blockers and prostaglandins. After prostaglandin discontinuation and a subsequent 2-week wash-out period, during which the patients received only beta-blockers monotherapy, latanoprost 0.005% analogue Prolatan (“Sentiss Rus”, India) was added to treatment. IOP was measured at the baseline level, after the wash-out period and 1, 2 and 3 months after the beginning of the new drug administration. Different samples of generic latanoprost 0.005% (Prolatan, “Sentiss Rus”, India) were analyzed in a certified laboratory by means of reverse phase highly efficient liquid chromatography using «Milichrom A-02» with an ultraviolet detector.
RESULTS: The study included 25 patients (45 eyes) with POAG. The average age of patients was 65.7±9.2 years. Baseline IOP in patients with basic therapy by non-fixed combination of beta-blockers and prostaglandin analogues was 19.47±2.08 mm Hg. After 3 months of combined therapy with latanoprost 0.005% analogue Prolatan level of IOP was 18.07±1.78 mm Hg. Comparison of baseline IOP level with post drug replacement therapy IOP level showed a statistically significant difference (p<0.05). The results of chromatography showed that different samples of generic latanoprost 0.005% (Prolatan, “Sentiss Rus”, India) are identical in composition and contain three peaks, each consisting of several components.
CONCLUSION: Obtained data allows us to recommend the use of generic forms of latanoprost 0.005% in combination therapy of patients with different stages of POAG.

PURPOSE: Evaluation of latanoprost efficacy and safety in patients with ocular ischemic syndrome.
METHODS: The material for this study comprised the results of comprehensive examination and treatment of 27 patients diagnosed with ocular ischemic syndrome (OIS). The average age of patients was 59.3±5.61 y., 11 women and 16 men. The main group included 12 patients, who received standard treatment in combination with once daily topical application of latanoprost: 1 drop into the conjunctival sac of one or both eyes affected with ischemic process. 15 patients of the control group received standard treatment.
RESULTS: After the treatment visual acuity of the affected eye improved by 29.8% in the main group and by 7.2% in the control group, while intraocular pressure in both groups remained within normal range. After the treatment the main group showed a significant improvement in standard automated perimetry (SAP) parameters: MD and PSD equaled -8.37±1.23 and -0.13±3.59 dB (p <0.05) respectively, while in the control group the same parameters amounted to 9.73±1.87 and -5.15±0.18 dB (p<0.05). Optical coherence tomography showed a decrease in edema of the optic disc and peripapillary zone. Kinetic perimetry showed a decrease in absolute scotoma size in both groups. The main group showed an improvement in blood flow parameters of the ophthalmic artery compared to baseline values: post-treatment increase by 36.9%, 37.1% at 1 month and 38.2% at 6 months. The control group hemodynamic parameters showed a post-treatment increase by 9.2%, 9.7% and 9.8% at the corresponding time points.
CONCLUSION: The use of standard therapy combined with latanoprost in the treatment of ocular ischemic syndrome has a positive effect on the course of the disease. It contributes to visual acuity increase, field of view limits expansion, reduced visual field sectoral loss, OCT parameters positive dynamics and ultrasonic Doppler examination hemodynamic parameters improvement.

PURPOSE: To compare the antihypertensive efficacy of prostaglandin analogues with prolonged hypotensive instillation therapy in subjects with newly diagnosed primary open-angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension.
METHODS: 98 subjects (176 eyes) with primary open-angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension were examined. All patients had a history of prolonged prostaglandins analogues treatment (2.40 (1.67; 2.9) years) by the beginning of our follow-up period. The final report of the research contains observation data collected before and after the treatment with prostaglandin analogues.
RESULTS: Due to the treatment, IOP was lowered from 24.80 (23.98; 26.13) to 21.00 (20.30; 22.00) mmHg over the course of the follow-up period (V=14782, p<2.2 e-16). Central corneal thickness, visual acuity and refraction in the study groups were comparable (p>0.05).
We recognized three types of therapy effectiveness: failure, temporary success and total therapy success. The percentage of treatment outcomes did not differ between the groups according to Fisher’s exact test (p=0.7177). Multiple linear regression revealed a statistically significant difference in average IOP reduction between primary open-angle glaucoma and pseudoexfoliation glaucoma groups. No statistically significant difference with ocular hypertension group was discovered. Significant predictors included average intraocular pressure level prior to treatment, central corneal thickness, average retina light sensitivity deviation and the interaction of two latter factors.
CONCLUSION: Long-term observation showed that with the same amount of visual field defects, central corneal thickness, visual acuity and refraction, prostaglandins analogues efficacy is higher in patients with pseudoexfoliation glaucoma compared to simple primary open-angle glaucoma (adjusted R2 =0.3, p=0.0003).

Neovascular macular degeneration treatment with repeated intravitreal injections may lead to both short-term and long-term elevations of intraocular pressure (IOP) level.
PURPOSE: To evaluate intraocular pressure changes in patients who received different amounts of endovitreal antiVEGF injections for macular pathology treatment.
METHODS: A retrospective analysis of 219 patients (219 eyes) with wet macular degeneration and persistent hypertension after intravitreal injections. All patients had injections performed only in one eye. The number of injections ranged from one to eight.
RESULTS: Follow-up showed a persistent IOP elevation in 18 patients. A relation between hypertension and AMD clinical manifestations has been revealed.
CONCLUSION: The retrospective analysis showed no significant correlation between the amount of hypertension cases and the number of injections.

PURPOSE: Analysis of technical characteristics of tomographic imaging methods and their impact on study results assessment.
METHODS: A retrospective evaluation of optical coherence tomography and Heidelberg retinal tomography data of 50 patients with macular area and optic disc pathology. The study was conducted using Nidek optical coherence tomography device and HRT-II retinal tomography device. Technical characteristics of obtained images, such as brightness, contrast, chromaticity, their interpretation and their impact on the diagnostic and treatment process were studied.
RESULTS: While analyzing optical coherence tomography and Heidelberg retinal tomography results for all of 50 patients (100%) we detected problems related to image quality. They are defined by specifications of the monitor and printer, characteristics of computer graphic, image visualization problems. Recommended display resolution is 1280×800 dpi or higher. Correct color reproduction of the image depends on the output resolution of the printer. Visualization of a three-dimensional object on a plane is currently under development. The process of transforming a 3D-object into 2D-graphics is often accompanied by software errors related to polygon conversion, as well as object «smoothing» and mapping when transferring it into a planar model. These technical issues do not have a significant impact on eye structures imaging in tomography studies. However, they may lead to inaccuracies in the assessment of morphometric parameters of the intraocular structures, which is significant in determining the dynamics of pathological processes.
CONCLUSION: Ophthalmologists studying ocular tomography results should have a clear understanding of possible technical errors and their causes. Computer diagnostic methods should be regarded as auxiliary. We recommend giving preference to clinical examination methods for diagnosis specification and assessment of the pathological process dynamics.

PURPOSE: Examine glaucoma incidence in the Republic of Bashkortostan (RB) over the 2010-2015 period.
METHODS: The data of «Medical Information and Analytical Centre of the Ministry of Health of Bashkortostan Republic» for 2010-2015 was analyzed during the research. We calculated the level of general and primary incidence per 100 thousand population, growth rate, share of glaucoma in the structure of the eye diseases and preventive medical examination rate. Indicators of general and primary disease incidence in Bashkortostan in comparison with similar indicators in the Russian Federation (RF) in 2010-2015 were analyzed.
RESULTS: Glaucoma incidence analysis showed an increase of its share in the structure of general and primary incidence among different population groups for 2010-2015. The study revealed general glaucoma incidence growth among general and adult population by 12.1% and 13.4% correspondingly compared to 2010. General incidence indicator decreased by 5.0% among the elderly population. Both primary incidence and preventive medical examination rate also increased in comparison with 2010. An increased primary disease incidence was marked in all age groups: among the entire population — by 48.6%, among the adult population — by 48.5% and among the elderly population — by 23.5%. Indicators of general and primary incidence in Bashkortostan were higher than national average.
In 2015, in the Republic of Bashkortostan 7.3 patients per 1,000 general population, 9.3 patients among the adult population and 25.0 patients among older working age population were subjects to regular glaucoma check-up, which was higher than in 2010 by 21.7, 22.4 and 5.5% respectively.
CONCLUSIONS: The research revealed an aggravating epidemiological situation with glaucoma in the Republic of Bashkortostan. General and primary incidence rates analysis showed negative trends in various demographic groups of this disease.

PURPOSE: To study the effect of conjunctival incision type in primary trabeculectomy on surgical site oxygen metabolism, complication rate and the hypotensive effect of the operation.
METHODS: 162 patients (200 eyes) with moderate and advanced primary open-angle glaucoma were randomized into two groups, 100 eyes each. All patients underwent primary trabeculectomy, Group 1 — with a fornix-based conjunctival flap, Group 2 — with a limbus-based conjunctival flap. Hemoglobin oxygen saturation (SO2), bleb hyperemia (H) and tonometry (IOP) were monitored on 1 day, 1 week, 1, 3, 6 and 12 months after the surgery. IOP compensation was assessed according to the Glaucoma guidelines average values: 17 mmHg for moderate glaucoma and 14 mmHg for advanced glaucoma.
RESULTS: Assessment of SO2 rates in conjunctival veins in the bleb zone on day 1 after the surgery showed a significant 17-18% decrease of oxygen saturation with no statistically significant difference between the groups. One week after trabeculectomy patients in both groups exhibited a tendency toward normalization of venous blood saturation rates with a statistically significant advantage of the first group: 46.1±3.4% and 36.8±3.6%. The tendency remains throughout the early postoperative period, reaching preoperative rates by 6 month after trabeculectomy: 55.6±2.2% and 54.8±2.3%. Difference between hyperemia rates was insignificant with ∆Н=-2.2%. 1 week after the surgery hyperemia in the fornixbased conjunctival flap group decreased by 3.6%, while limbus-based conjunctival flap showed a decrease of only 0.8% (statistically significant difference). This index gradually lowered to normal values up to 3-6 months after trabeculectomy in both groups; however a difference of 2-3% remained until the 3d month.
There was no significant difference in preoperative IOP rates: 28.4±5.6 and 28.7±5.8 mmHg. On day 1 after surgery IOP lowered to 9.2±1.9 и 8.4±2.3 mmHg correspondingly. Similar values were noted on 1 week timepoint (insignificant difference). 1 month after the operation IOP rate in Group 2 exceeded those in Group 1 by 1.5 mmHg with no evident reason. This tendency continued up till 1 year, reaching a statistically significant difference at 3 months and 1 year after trabeculectomy (3.6, 1.5 and 4 mmHg at 3, 6, 12 months correspondingly).
At the end of the follow-up period absolute surgical success equaled 69 and 54% in Groups I and II correspondingly (insignificant difference). Bleb needling was required in 26 and 37% of cases, postoperative hypotensive therapy — in 18 and 25%. Relative surgical success showed a moderate difference, equaling 95 and 91%.
No conjunctival perforation during fornix-based conjunctival flap incision was noted. In limbus-based conjunctival flap group there were 4 cases of perforations in the paralimbal zone. Shallow anterior chamber was noted intraoperatively in 18 and 23% of cases. Fornix-based conjunctival flap required additional sutures in 9% of cases. No such necessity was noted in the limbus-based conjunctival flap group. Postoperative hyphema was registered in 7 and 11% of cases, disadaptation of the edges of the conjunctival incision was visualized in 14 and 2% of cases, external filtration — in 8 and 2%. Choroidal detachment developed in 7 and 11% of cases, with 4 and 5% requiring surgical treatment.
CONCLUSION: Trabeculectomy with both fornix-based and limbus-based conjunctival flap incision leads to a substantial metabolic disturbance at the operation site, leading to a significant increase in oxygen consumption and surgical site hyperemia — with a significant advantage on the part of the fornix-based conjunctival flap. It is a less traumatic method of forming a conjunctival flap, associated with lower perforation and choroidal detachment incidence.
Limbus-based conjunctival flap showed better results in terms of conjunctival incision disadaptation and additional suture necessity. Both methods showed comparable qualified surgical success rates with a significant difference in postoperative hypotensive measures.

Cataracts and glaucoma are the main reasons for visual acuity decrease among the eye diseases in people older than 50 years. Over 50% of patients with primary openangle glaucoma use local antihypertensives on a constant basis. In recent years, prostaglandin analogues (PA) have served as the drugs of choice for treating glaucoma. They improve the uveoscleral outflow of aqueous humor and have a high antihypertensive efficacy. On the other hand, since PA exhibit general properties of mediators of inflammation, they may induce vasodilation, increase vascular permeability and enhance promotion of exudative processes. In some cases this group of drugs may lead to blood-ocular and blood-retinal barriers breach that in turn may provoke the development of cystoid macular edema including early postoperative period after cataract extraction. The paper provides information on some studies relating to the impact of PA on the postoperative period after phacoemulsification. At present, there is no unequivocal opinion on this question.

Cytokines are a group of regulatory protein mediators. They perform a key role in the development and regulation of inflammatory response, reparative and plastic processes. Cytokines are an important part of humoral immunity and can be synthesized by a variety of cells. On the organism level cytokines create a complex selfregulating system, collectively referred to as the cytokine network. This review provides a brief history of cytokines development, from the first experiments of Coley W. to the introduction of modern classification. The review describes cytokine families that are most frequently studied in the ophthalmologic researches; studies of local and system cytokine profile changes in patients with eye diseases are summed up. Reviewed clinical and laboratory studies relate the influence of different cytokine groups on the inflammation process in patients with various forms of uveitis, effect of cytokines on the development of glaucomatous optic neuropathy and cytokines’ role in other ophthalmic diseases. These researches allow a better understanding of the mechanism of ocular immune privilege and study of ocular diseases pathogenesis on the molecular level. Cytokine research also helped discover the chronic inflammatory component of primary open-angle glaucoma and keratoconus, explain different kinds of inflammatory response in secondary uveitis, and discover new prognostic methods. This new data enables the development of new methods of pathogenetically oriented eye diseases therapy.

The review discusses different electrophysiological methods of examination and their role in glaucoma diagnostics. Electrophysiological methods allow a recording of bioelectrical potentials that are generated by the neurons of the visual system in response to flash and pattern stimulation. Compared to imaging techniques in ophthalmology (optical coherence tomography, fluorescein angiography or ultrasound sonography), the electrophysiological methods are functional tests, as the evoked bioelectrical potentials are by-products of signal processing within the visual pathway. Compared to psychophysical procedures in ophthalmology (perimetry, visual acuity, color vision testing) the electrophysiological methods allow to reveal an objective localization of functional deficits, as the type of the recording enhances the contribution of specific neurons along the visual pathway (photoreceptors, bipolar cells, ganglion cells, or optic nerve). Different electrophysiological examination methods of various neuronal structures of the visual pathway have been improved during the past decades. Most of them play an important role in distinguishing glaucoma from other diseases of the visual system.