Features of Monitoring Patients with Primary and Advanced Stages of Glaucoma in Krasnodar Territory

Abstract

Purpose: to analyze the monitoring of patients with primary and advanced stages of glaucoma, who applied to the private clinic “Tri-Z” (Krasnodar).Patients and Methods. A total of 3 524 patients underwent screening with a diagnosis of glaucoma for all over 2018 at the clinic, of which 55.6 % were diagnosed with primary and advanced glaucoma. The criterion for inclusion in the study was primary glaucoma of the initial and advanced stages, elimination criteria: high degree of refraction errors, retinal detachment in anamnesis, proliferative diabetic retinopathy, AMD exudative forms, congenital forms of glaucoma, secondary types of glaucoma.Results: The average age of patients was 68.44 ± 8.142 years, women were 71 %, men — 29 %. The average duration of glaucomatous history was 3.48 ± 3.525 years. POAG was found in 85.3 % of cases, PACG in 14.7 % of cases. Glaucoma without concomitant PEX was observed in 44.7 % cases, with signs of PEX in 55.3 % cases. In stage I of glaucoma, the majority of patients (42.7 %) received APG and in 27.1 % cases a fixed combination of ICA + BB. In stage II glaucoma, the majority of patients (26.5 %) received a fixed combination of ICA + BB, in 18.8 % of cases, the combination of APG + ICA + BB and in 17.7 % — APG. The share of laser interventions: LTP — 14.7 %, SLT — 4.1 %, peripheral iridectomy — 10 %, YAG-GP — 0.8 %, SLT + YAG-GP — 0.8 %, peripheral iridectomy + SLT — 0.5 %. The share of surgical interventions: at glaucoma stage I non-penetrating deep sclerectomy (NPDS) — 3.4 %; at stage II NPDS — 10.9 %, repeated NPDS — 0.5 %, deepsclerectomy — 2.2 %; phacoemulsification + IOL — 21.9 % of cases.Conclusion: In the study, we noted the following features: use, including as a starting therapy, effective drugs or their combinations; the preferred use of fixed combinations; prioritization of non-preservative therapy; high frequency of laser interventions in the anterior eye segment; use of peripheral laser iridectomy in the overwhelming majority of cases when PACG is detected; early transition to surgical treatment.