Introduction. For the past several decades, there has been a discussion as to whether elevated intraocular pressure is just ocular hypertension in a healthy eye, or a sign of glaucoma. Objective. To study the IOP values in patients with primary open-angle glaucoma at the beginning of the study and to correlated them with the disease progression and to determine optimal IOP levels. Material and methods. The final protocol included data from 812 right eyes of 637 glaucoma patients and 175 healthy subjects; the latter formed the control group. The mean age of examined patients was 71.8 ± 0.28 years; 72.00 (66.00; 77.00). Mean disease duration in glaucoma patients was 5.41 ± 0.17 years. The following parameters were assessed: visual acuity, clinical refraction, IOP level by Maklakov tonometry, central corneal thickness and IOP-lowering medication use. Results. In the age group - between 60 and 69 y.o., the IOP level in patients with advanced glaucoma was significantly higher than in patients with moderate glaucoma and healthy subjects. There was no significant difference in central corneal thickness either between glaucoma patients and healthy subjects (both male and female) or between glaucoma patients with different glaucoma changes. The IOP level was higher in patients treated with non-fixed combination of beta-blockers (BB) and prostaglandins (PG) regardless of the disease stage. According to the common standards the IOP level was found to be controlled in 69.93 % of patients with moderate glaucoma and 14.42 % of patients with advanced glaucoma. Conclusion. The results of the study could be used as clinical guidelines for determination of the optimal IOP range, choosing the optimal IOP-lowering medication(s) for starting therapy and during the follow-up in patients with moderate and advanced glaucoma stages.
Objective: to determine the efficiency of the treatment for glaucoma and its accompanying costs in patients with II-III stages of open-angle glaucoma. Material and methods. The multicenter study which was conducted by 35 investigators in 29 clinical centers in 4 CIS countries from December 2013 to April 2014 took into account the results of the treatment of 115 patients (187 eyes) with glaucoma. The cost and «cost-effectiveness» of the intraocular pressure (IOP)-lowering treatment were calculated with the account of IOP-level compensation. Results. The average cost-effectiveness was 13.94 ± 0.66 rubles/day, which was comparable to the theoretical cost of the treatment but 32 % exceeded the price that patients actually paid for the treatment. As for the monotherapy with prostaglandin preparations and the fixed combination of beta-adrenoblocker and prostaglandin analogue (BB + PG), the difference between the actual price and cost-effectiveness was 44 %. At the same time, this difference in the application of the fixed combination of beta-adrenoblocker and carbonic anhydrase inhibitor (BB + CAI) made up 64 %. Conclusion. It is cheaper to achieve a controlled IOP level in the application of the fixed combination BB + PG compared to the BB + CAI fixed combination treatment.
Objective: to study the intraocular pressure (IOP) in patients with primary open-angle glaucoma during the treatment with hypotensive drugs depending on age, medical history, stage of disease and the central thickness of the cornea. Material and methods. 812 right eyes of 812 patients were examined, 637 of 812 were glaucoma patients and 175 healthy people of the control group. Results. The level of the intraocular pressure was significantly higher in patients with severe glaucoma than in patients with moderate glaucoma or healthy people. There was no significant difference in the central corneal thickness between glaucoma patients and healthy people (both male and female). The IOP level was higher in the group of patients treated with non-fixed combination of beta-blockers and prostaglandins regardless of the disease stage. The IOP compensation was found in 69.9 % of patients with moderate glaucoma and 14.4 % of patients with severe glaucoma. Conclusion. The results of the study can be used as clinical guidelines for determination of the optimal IOP range while choosing the optimal IOP-lowering medications at the start of therapy and during the follow-up of patients with moderate and severe glaucoma.
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