Structural and functional changes in the retinal layers in patients with primary glaucoma and possible means of retinoprotection

Abstract

To study the structural and functional changes occurring in the retina and the effect of peptide bioregulator on the state of various retinal layers in patients with primary open-angle glaucoma (POAG). The study included 62 patients (123 eyes) with POAG. The control group consisted of 25 people (50 eyes) of the same age. After the initial examination, patients of the glaucomatous group were divided into two equal subgroups. Patients of the first subgroup received 10 intramuscular injections of the peptide bioregulator; in the second subgroup, patients did not receive any retinoprotective therapy. The state of the visual analyzer was assessed using spectral optical coherence tomography (SOKT), electrophysiological research methods (ERG, PERG, flicker ERG), photostress test. Patients with POAG were found to have current and developing changes in the thickness and the configuration of various layers of the retina in the macular area as the disease progresses - particularly, in the nerve fiber layer (p=0.02), ganglion cells (p=0.002), inner nuclear layer (p=0.003) and the layer of pigment epithelium (p=0.049). Electrophysiological research methods helped reveal statistically significant changes in the functional parameters reflecting the generation and conduction of nerve impulses in retinal layers in patients with glaucoma. The patients undergoing peptide bioregulator therapy showed statistically significant positive changes in the state of ganglion cells observed as a decrease in the latency of the PERG N-95 wave (p=0.002) and stabilization of the structural indicators of SOCT (RNFL peripapillary zone). Patients with POAG exhibit progressive decrease in the thickness of not only the inner, but also the outer layers of the retinal macular area. According to objective structural and functional criteria, retinoprotective therapy leads to stabilization of the glaucomatous process.