NEW POSSIBILITIES OF CONSERVATIVE TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA
About the author:
Rykov S., Mogilevskyy S., Petrenko O., Denisyuk L., Medvedovska N., Korytnyuk R.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
According to modern concepts, primary glaucoma is a multifactorial disease with a threshold effect, which is one of the most common optical neuropathies (glaucoma optic neuropathy, GON). GON is based on apoptosis of retinal ganglion cells (RGC) and optic nerve (ON). In the nosological structure of primary disability among the adult population in Ukraine, glaucoma is 0.32 per 10,000 of population. During the recent decade, glaucoma is confidently amongst the top three leaders of the main causes of vision impairment. The analysis of factors and causes of disability among patients with glaucoma indicates that over the past three years, the main cause of disability is the inability of the population to withstand the burden of too high costs for effective treatment of glaucoma. Local antihypertensive therapy of primary glaucoma is one of the main methods of its medical treatment. As a rule, the therapeutics starts with it. Its goal is to preserve visual functions, achieve a therapeutic effect with a minimum number of drugs and a multiplicity of instillations, and maintain the habitual quality of life with adequate material costs for the patient. In everyday practice, ophthalmologists often face a situation where, after careful examination of complaints, a history of illness and life, and all studies, it becomes clear that local first-choice antihypertensives will not be effective or systemic side effects pose a big risk to a particular patient (this applies to a large extent to non-selective β-adrenoblockers). In our opinion, a hypotensive agent of choice in these cases may be brimonidine. Its use reduces ophthalmotonus by 20-30%. In addition, this drug has a direct and indirect neuroprotective effect. The aim of the study was to research new possibilites of conservatve treatment of various forms of primary open-angle glaucoma with the use of brimonidine. 160 patents (182 eyes) with primary open-angle glaucoma have been observed: 77 men and 83 women. The frst group consisted of patents with newly diagnosed open-angle glaucoma I-IV stage, high level of tonometric true IOP, and a history of cardiovascular and pulmonary pathology; the second group – patents with operated primary glaucoma; the third group – patents afer combined surgical treatment of glaucoma and cataract. All conducted local hypotensive monotherapy with selectve sympathomimetc brimonidine (Luxfen). Our studies showed a high hypotensive and neuroprotective effect of local antihypertensive monotherapy with selective symphotomimetics Luxfen, both in patients with newly diagnosed POAG, and after performing surgical treatment of POAG and combined treatment of POAG and cataract. High efficacy and safety of Luxfen allows us to recommend it as a first-choice drug for patients with primary open-angle glaucoma and concomitant cardiovascular and pulmonary pathology for simultaneous reduction of IOP and protection of ganglion cells of the retina in POAG.
primary open-angle glaucoma, conservative treatment, brimonidine
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 184-188 pages, index UDK 617.7-007.681-021.3:612.015