Multicenter study of intraocular pressure level in patients with moderate and advanced primary open-angle glaucoma on treatment

Abstract

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.

Ocular hypotensive effect of systemic beta-blockers in patients with primary glaucoma and arterial hypertension

“…В качестве рекомендуемых лекарственных средств для лечения систолодиастолической АГ и ИСАГ у пожилых больных старше 60 лет также используются препараты, ингибирующие ренин-ангиотензин-альдостероновую систему (ИРААС), -ингибиторы ангиотензинпревращающего фермента (ИАПФ), АРА и β-адреноблокаторы (БАБ) [4]. Известно, что β-блокаторы широко назначают офтальмологи при лечении глаукомы и врачи-интернисты для лечения АГ [5,6]. С другой стороны, в литературе имеется недостаточно сведений об офтальмогипотензивном эффекте системных β-блокаторов [7][8][9][10].…”