FEATURES OF THE COURSE OF PRIMARY OPEN-ANGLE GLAUCOMA IN PATIENTS WITH PRIMARY MANIFEST HYPOTHYROIDISM
About the author:
Bezditko P. A., Babak Yu. A., Savelyeva A. Yu.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Population studies have found that the prevalence of glaucoma in a population with thyroid problems is 11.9% versus 4.6% in the general population. Thyroid hormone deficiency may be accompanied by excess hyaluronic acid, trabecular edema, and impaired intraocular fluid outflow. According to other data, the incidence of subclinical hypothyroidism reaches 8.5% compared to 0.4% of the clinical form. According to other authors, the overall prevalence of manifest hypothyroidism in the population is 0.2-2%, subclinical – approximately, 7-10% among women and 2-3% among men. Object and methods. There were 90 patients (90 eyes) under the control of POAG who were divided into 2 groups. Group 1 observation consisted of 40 patients (40 eyes) on PCAG in combination with primary manifest hypothyroidism. Group 2 (control group) consisted of 50 patients (50 eyes) on POAG without endocrine pathology. All patients were analyzed morphofunctional and tonometric indicators of the organ of vision, namely visual acuity, IOP, perimeter Humphrey (MD, PSD), optical coherence tomography (Area cup / disc ratio, RNFL and Vrim). Results. In the examination of patients with PVG with primary manifest hypothyroidism, it was found that the visual acuity was – 0.86±0.12, IOP – 25.8±5.22 mm Hg, the MD – -21.3±3,2 dB, PSD – 8.68±1.3, Area cup / disc ratio – 0.87±0.08, RNFL – 60.42±2.5 μm, Vrim – 0.07±0,01 mm3 . Conclusions. Patients with PVG with primary manifest hypothyroidism have a more severe course of the glaucoma process compared with patients without endocrine pathology. Patients with POAG with primary manifest hypothyroidism had a statistically significant (p <0.05) decrease in visual acuity of 69%, increased IOP by 21%, decreased MD by 187%, increased PSD by 119%, increased Area cup / disc ratio by 50%, reduction of RNFL by 39%, reduction of Vrim by 100% at a 3-year follow-up. In patients with PCG without endocrine pathology statistically significant (p <0.05) reduced visual acuity by 26%, increased IOP by 10%, decreased MD by 54%, increased PSD by 82%, increased Area cup / disc ratio by 39%. Reduced RNFL by 10%, reduced Vrim by 67% at a 3-year follow-up.
primary open-angle glaucoma, manifest hypothyroidism, perimetry, optical coherence tomography.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 92-98 pages, index UDK 617.7-007.681-073:616.441-008.64