Abstract
Purpose: to develop a comprehensive algorithm for choosing the optimal method for monitoring and treating patients with primary openangle glaucoma (POAG). Material and methods. 30 patients with POAG, aged 30 to 86, underwent an ophthalmological examination which included visometry, standard automatic perimetry, tonometry, ophthalmoscopy, and biomicroscopy. The data obtained were evaluated on a point scale according to the innovative algorithm, on the basis of which a plan of patient management was recommended. Then the recommendation of the algorithm was compared with the suggestion of an expert specializing in the treatment of glaucoma. Results. The proposed innovative algorithm for treating POAG patients sets up four stages in the appointment of topical hypotensive therapy. When gaining a certain number of points, the algorithm recommends surgical treatment. The treatment tactics suggested by the algorithm, agreed with the opinion of glaucoma expert in most of the cases (27 out of 30 cases; 90%). Conclusion. An algorithm for the treatment of patients with POAG has been proposed and tested. The algorithm makes it possible to assess the progression of the glaucomatous process and select the optimal tactics for managing the patient in real time of examination.
Highlights
Ключевые слова: первичная открытоугольная глаукома; прогрессирование глаукомы; хирургическое лечение; стартовая, усиленная, комбинированная и максимальная терапия глаукомы Конфликт интересов: отсутствует
The proposed innovative algorithm for treating primary openangle glaucoma (POAG) patients sets up four stages in the appointment of topical hypotensive therapy
The treatment tactics suggested by the algorithm, agreed with the opinion of glaucoma expert in most of the cases (27 out of 30 cases; 90%)
Summary
Данные осмотра (стадия глаукомы, уровень ВГД, прогрессирование по данным КП, факторы риска, наличие местной гипотензивной терапии или SLT, переносимость гипотензивных средств) Examination data (stage of glaucoma, IOP level, progression according to CP data, risk factors, presence of local antihypertensive therapy or SLT, tolerance of antihypertensive drugs). Ст.), недостаточно данных при отсутствии 3 исследований, один из факторов риска, местная гипотензивная терапия не проводилась, переносимость хорошая Suspected glaucoma, borderline (21 mm Hg), insufficient data in the absence of 3 studies, one of the risk factors, local antihypertensive therapy was not performed, tolerance is good. Ст.), недостаточно данных при отсутствии 3 исследований, 2 фактора риска, комбинированная (Тизоптан® 1 р/д), переносимость хорошая Advanced glaucoma, significantly increased (31 mm Hg), insufficient data in the absence of 3 studies, two risk factors, combined (Tisoptan® once a day), good tolerance. Ст.), не выявлено, не выявлено, местная гипотензивная терапия не проводилась, переносимость хорошая Glaucoma suspected, normal (18 mm Hg), not detected, not detected, local antihypertensive therapy was not performed, tolerance is good Подозрение на глаукому, нормальный (18 мм рт. ст.), не выявлено, не выявлено, местная гипотензивная терапия не проводилась, переносимость хорошая Glaucoma suspected, normal (18 mm Hg), not detected, not detected, local antihypertensive therapy was not performed, tolerance is good
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