PURPOSE. To study the clinical and demographic characteristics of patients with end-stage primary open-angle glaucoma (POAG).

METHODS. The study included 159 patients (318 eyes) with a median age of 72.2 years (64.7; 79.7), with end-stage POAG in one eye. All patients underwent a comprehensive ophthalmologic examination, with a thorough review of medical history and records. Data were processed by a single investigator with subsequent selective verification.

RESULTS. More than 50 clinical and demographic characteristics of patients with end-stage POAG were analyzed, focusing on four key factors: age, duration of follow-up, stage at the time of diagnosis, intraocular pressure (IOP), and history of incisional surgery. The IOP values significantly exceeded the target values, averaging 23 mm Hg (18; 32), indicating a need for more aggressive treatment. The mean disease duration before reaching the end stage of POAG was 3.9 years (0.7; 7.5). The progression of POAG was markedly asymmetric: patients with early-stage disease progressed to the end stage in 7 years (4; 12); those with moderate-stage disease progressed in 7.9 years (4; 11.9); and those with advanced-stage disease progressed in 4 years (2.2; 5.9). Regular monitoring (at least four times a year) was associated with a more than twofold delay in disease progression. The duration of disease ("up to" or "more than" 5 years) and previous surgical treatment ("yes" or "no") had an equal impact on disease development and its progression to the end stage, indicating that rather than the fact of surgery itself, the most crucial is the timing of surgery. Surgical intervention in patients with advanced stages of glaucoma, when followed up for more than 2 years (0.65; 4.6), was insufficiently effective, suggesting the need for earlier surgical intervention.

CONCLUSION. Aiming to facilitate a personalized approach to treatment, we created a risk assessment algorithm for the development of end-stage POAG for use in clinical practice.

PURPOSE. To assess the proportion of primary openangle glaucoma (POAG) among the patients of the diagnostic and treatment department (DTD).

METHODS. All cases of patients with POAG presenting to the DTD during the first six months of 2022 were selected using continuous sampling. Standard ophthalmological examination was conducted. The retinal nerve fiber layer and ganglion cell complex were assessed using optical oherence tomography. Intraocular pressure (IOP) was measured using the Maklakov method, and some patients underwent point contact tonometry.

RESULTS. A total of 236 patients with POAG (6.1%) sought medical care during the specified period. Among them, stage I POAG was diagnosed in 37.7%, stage II — in 27.9%, stage III — in 26.6%, and stage IV POAG — in 7.7%. In 79.6% of cases IOP was normal, in 15.7% it was moderately elevated, and in 4.6% it was high. In 60.1% of patients IOP values were intolerant, 27.3% of patients were not on a hypotensive regimen, and 19.6% used it irregularly. The target IOP level was achieved in 47.1% of patients who adhered regularly to the hypotensive regimen. POAG was newly diagnosed in 68 patients (28.8%).

CONCLUSION. 1. A low adherence to glaucoma treatment was identified, with 27.3% of patients not receiving any hypotensive therapy and 19.6% showing partial adherence.

1. A consistently normalized IOP level, according to the optimal upper limit values, was achieved in only 25% of patients under hypotensive therapy.
2. The proportion of newly diagnosed glaucoma cases among the total number of patients presenting to the DTD was significant (1.75%), accounting for 28.8% of all analyzed POAG cases.

PURPOSE. To evaluate the effectiveness of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with decompensated glaucoma.

METHODS. The analysis included a total of 54 eyes with decompensated glaucoma that underwent MP-TSCPC. The mean age was 62.83±1.75 years. The follow-up period lasted up to 3 months. Advanced-stage glaucoma was observed in 18 eyes, and terminal-stage glaucoma in 34 eyes. Primary glaucoma was present in 37 eyes, and secondary glaucoma in 14 eyes. A reduction in intraocular pressure (IOP) of more than 20% from baseline was considered a successful outcome.

RESULTS. The baseline IOP was 38.97±1.94 mm Hg, with an overall hypotensive effect of 26%. The overall effectiveness of mCPC was 75.9%.

In terminal-stage glaucoma, IOP reduction by the end of the third month after MP-TSCPC was 23%, with an effectiveness of 76.5%. In advanced-stage glaucoma, IOP decreased by 16% by the end of the third month, with an effectiveness of 75%.

For primary glaucoma, the IOP reduction at 3 months was 32.5%, and for secondary glaucoma, it was 22%. Prior to MP-TSCPC, patients had been using an average of 3.075 types of eye drops, which remained unchanged after the procedure. The effectiveness of MP-TSCPC did not differ between operated and non-operated eyes. When MP-TSCPC was performed to relieve pain, success was achieved in all cases. During the study period, one patient underwent a repeat MP-TSCPC, and another underwent an antiglaucoma filtering surgery. No complications were observed in any of the cases.

CONCLUSION. MP-TSCPC is an effective intervention with a safe early postoperative period. We observed a significant hypotensive effect in eyes with preserved visual function and effective pain relief. Further follow-up of these patients is necessary, as well as the expansion of indications for use in earlier stages.

PURPOSE. To identify the characteristics of ocular hydrodynamic parameters in primary open-angle glaucoma (POAG) in patients with type 2 diabetes mellitus (DM).

METHODS. The study examined a total of 200 patients (280 eyes), including 110 patients (220 eyes, main group) with POAG and type 2 DM, 30 patients (60 eyes, control group 1) with type 2 DM without glaucoma, and 60 patients (106 eyes, control group 2) with POAG without diabetes. Tonography was performed using the GlauTest–60 device in addition to standard methods of ophthalmological examination.

RESULTS. In the main group, a reduction in true intraocular pressure (P0) was observed in advanced and early stages of glaucoma, with values of 24.6±0.45 mm Hg (80 eyes) and 21.6±0.4 mm Hg (136 eyes), respectively, compared to 21.8±0.6 mm Hg and 17.9±0.63 mm Hg (p<0.05) in control group 1. The ease of outflow coefficient (C) decreased to 0.11±0.08 mm³/min/mm Hg and 0.14±0.06 mm³/min/mm Hg in the main group, compared to control group 1, where it was -0.15±0.006 mm³/min/mm Hg and 0.27±0.036 mm³/min/mm Hg, respectively (p<0.05; p<0.01).

In the main group, an increase in P0 and a decrease in C were more pronounced as glycosylated hemoglobin (HbA1C) levels in the blood exceeded 7.5% and in cases of diabetic retinopathy at stages II and III.

CONCLUSION. In patients with uncontrolled type 2 DM and increasing HbA1C levels, there is a significant increase in P0 and a decrease in C. This highlights the need for continuous monitoring of hydrodynamic parameters.

PURPOSE. To conduct a comparative evaluation of the efficacy and safety of medication-based hypotensive therapy versus selective laser trabeculoplasty (SLT) in patients with newly diagnosed primary open-angle glaucoma (POAG).

METHODS. The study included 59 patients with POAG (59 eyes), divided into two groups. Group 1 received monotherapy with tafluprost, while Group 2 underwent SLT. In cases of intraocular pressure (IOP) decompensation during the follow-up period, Group 1 was prescribed additional topical therapy or switched to SLT, and Group 2 was started on topical therapy. The follow-up lasted 6 months. The study assessed the hypotensive efficacy of the treatments and the condition of visual functions.

RESULTS. By the end of the observation period, the hypotensive efficacy in Group 1 was 24%, with an IOP level of 20.1±1.6 mm Hg. Some adverse effects related to topical therapy were observed. In Group 2, the hypotensive efficacy was 20.5%, with an average IOP level of 16.8±2.0 mm Hg. No adverse events were reported in Group 2.

CONCLUSION. Preliminary outcomes indicate that the hypotensive efficacy of monotherapy with prostaglandin analogues and SLT is comparable. The clear advantages of laser treatment include reduced adverse effects, which promotes better compliance, adherence to treatment, and decreased risk of disease progression.

The pathogenic role of choriocapillaris blood flow in the progression of glaucomatous neurodegeneration has long been discussed in the literature. However, in vivo visualization of the deep microcirculatory structures in the peripapillary zone has remained challenging for a long time.

Modern diagnostic methods, such as optical coherence tomography (OCT), particularly spectral domain OCT (SD-OCT), swept-source OCT (SS-OCT), and OCT angiography, now enable the visualization of deep ocular vessels, including the choriocapillaris layer, opening new possibilities for diagnosing and monitoring the progression of glaucoma. This review provides information on the anatomy of the choroid, the choriocapillaris layer, its role in the pathogenesis of glaucoma, as well as the latest methods of studying these structures using optical coherence tomography.

The relationship between glaucoma and retinal vein occlusion (RVO) has been a subject of ongoing scientific interest. Several population-based studies have identified glaucoma as a significant risk factor for the development of RVO. However, data on the relationship between different types of primary glaucoma and RVO remain contradictory. Clarifying the nature of this relationship and identifying its possible pathogenic basis could improve treatment approaches for these conditions.

This review summarizes information on the relationship between various types of primary glaucoma and RVO, establishes the role of primary open-angle glaucoma as a risk factor for RVO development, and discusses the impact of localized hemodynamic disturbances on the development and progression of primary open-angle glaucoma. The article also notes the different ways in which primary angle-closure glaucoma can affect the development of occlusion of central retinal vein and its branches, and summarizes the information on the influence of medications used to treat macular edema in RVO on intraocular pressure. Recommendations are provided on the selection of treatment methods for macular edema associated with retinal vein occlusion, taking into account the presented data.