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This paper reviews the literature on the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in the diagnosis of glaucoma and considers the significance of evaluating retinal nerve fiber layer and ganglion cell complex in assessment of glaucoma progression, variability and reproducibility of the method, as well as the influence of age-related retinal changes on the results, analyzes the role of OCTA in glaucoma monitoring. Optical coherence tomography is a modern standard for glaucoma diagnosis and monitoring, and OCTA shows high potential as an auxiliary diagnostic tool.

The most well-studied and widely prescribed fixed-combination drug for open-angle glaucoma is latanoprost/timolol. Its significant hypotensive effect is especially important in challenging cases, among which are patients with normal-tension glaucoma. With long life expectancy and the constant need for treatment, requirements are high for both the effectiveness of the drug and its tolerability. This paper presents a follow-up of 7 patients with normal-tension glaucoma who have been using the fixed combination of latanoprost/timolol for 10 years. All patients showed very good tolerability to the drug and their quality of life was preserved. A moderate rate of disease progression according to static perimetry was noted in one case. A mild degree of dry eye syndrome according to the OSDI questionnaire and an objective assessment of the state of the ocular surface was observed in one patient. The latanoprost/timolol fixed combination is a well-tolerated, highly effective and safe long-term treatment choice for normal-tension glaucoma.

The paper describes the role of endogenous glucocorticoids in the pathogenesis of open-angle glaucoma. As to steroid-induced glaucoma (SG), however, indicators of systemic and local cortisol metabolism are yet underinvestigated. Aim - to determine and compare systemic (plasma) and local (aqueous humour) cortisol concentrations in patients with SG and other types of glaucoma (OTG)., Material and Methods: A prospective analysis was conducted in 64 patients who underwent plasma and aqueous humor sampling. All the patients were divided into 4 groups: group 1 - 11 patients with steroid induced ocular hypertension (SOH) and SG; group 2 - 31 patients with OTG; group 3 - 10 patients on steroid therapy (ST) without a so called 'steroid response'; group 4 - the controls (12 patients with cataract)., Results: The mean cortisol levels in plasma and aqueous humour were the following: 177.5±29.4 ng/ml and 53.1±12.2 ng/ml in patients with SOH and SG; 277.7±33.6 ng/ml and 44.6±4.4 ng/ml in patients with OTG; 125.2±28.1 ng/ml in patients on ST; 147.2±19.1 ng/ml and 29.8±3.2 ng/ml in the controls. The highest plasma and aqueous humour cortisol levels were found in groups 2 and 1, respectively., Conclusion: Plasma and aqueous humour levels of cortisol appeared to be higher in glaucoma patients than in the controls. Taking into account the fact that plasma cortisol levels are higher in steroid responders, it is recommended that all patients on ST undergo cortisol testing.

The paper presents the results of practical application of a new screening method for determining tolerant intraocular pressure (TIOP) on a Blood Flow Analyzer (Paradigm, USA). Studies were conducted on 331 eyes (205 subjects). Group 1 consisted of 80 patients (126 eyes) without glaucoma being found, with intraocular pressure (IOP) in the average normal range, but with a TIOP excess of 1-8 mm Hg (a risk group); Group 2 included 15 subjects (20 eyes) without glaucoma with normal IOP in whom TIOP exceeded the existing IOP by 1-7 mm Hg; Group 3 comprised 110 patients (185 eyes) with Stage I-III primary open-angle glaucoma (POAG) with compensated IOP. Morphofunctional studies revealed glaucoma in 95 (75%) eyes in the risk group: Stages II and I in 61 and 30%, respectively; and advanced glaucoma in 9%. At the same time, there was a close correlation of the probable detection of glaucoma with the existing degree of a TIOP excess. No cases of glaucoma were observed in Group 2. The determination of TIOP and morphofunctional changes over time in Group 3 revealed a stable glaucomatous process in 99% of cases in which IOP was lower than or equal to TIOP, as well as progressive glaucomatous neuropathy in 91% in which compensated LOP exceeded TIOP. The results of the study in Group 3 suggest that the index TIOP may be used as a guide of IOP in the treatment and monitoring of POAG. The presented data indicate that the determination of the level of TIOP is a required element of both standard ophthalmological examination and monitoring of glaucoma.

This paper presents an analytical survey of the Russian and foreign literature dealing with the current idea on the pathology of a glaucomatous process and methods for the early diagnosis of glaucoma. It gives data on the impact of intraocular pressure, central corneal thickness and ocular biomechanical properties on the pathogenesis of primary open-angle and normotensive glaucoma. The results of electrophysiological, psychophysiological, ultrasound, and morphometric studies were assessed in the diagnosis of primary open-angle glaucoma.

The paper considers the possibilities of using multifocal electroretinography (mfERG) to examine patients with primary glaucoma. Forty-seven patients underwent mfERG that established that as the disease progressed, there were reductions in the mfERG wave amplitude, when the first flash response, and in biopotential density, when the quadrant analysis was made. Biopotential changes in glaucoma can be analyzed in relation to the first flash response and a pattern response. Monitoring of changes in primary glaucoma may use mfERG.

The paper discusses the impact of some properties of corneal tissue (central corneal thickness, curvature radius, elasticity, etc.). The dynamic bilateral applanation process underlying the ocular analyzer provides exact information on the index determining the viscoelastic properties of the cornea - corneal hysteresis. The author presents the results of detecting corneal hysteresis in individuals without oculopathy and in patients with glaucoma, as well as the association of this index with the central thickness of the cornea, the levels of corneal compensated pressure, and the intraocular value equated to the Goldman tonometric index.

The paper analyzed the immediate and late results (the state of intraocular pressure and visual functions) of combined surgery for cataract and glaucoma, by using the developed instrument. Eighteen patients (19 eyes) aged 54 to 92 years who had open-angle glaucoma or phacotopic glaucoma (dislocation of the lens to the vitreous body) and cataract underwent combined surgery involving extraction of cataract, its phacoemulsification with intraocular lens (IOL) implantation through the scleral tunnel, and sinus trabeculectomy (STE) performed with a perforator, the instrument developed by the authors. The findings confirm the efficiency of the combined surgery (STE) with cataract extraction through variously extended scleral tunnels in patients with open-angle glaucoma, normalizing intraocular pressure and improving visual functions by one-stage surgery. Combined surgery for cataract extraction with IOL implantation through the scleral tunnel and STE, which is performed with the instrument proposed by the authors, has been put into practice.

The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

The paper presents the results of studies made in patients with different stages of primary open-angle glaucoma, by using oscillatory potentials (OP). A significant inverse relationship was established between the OP index and the intraocular pressure; the OPI index was decreased in progressive glaucoma. The findings suggest that neuronal relationships are impaired in the proximal retina in glaucoma due to its ischemic processes.

The paper presents the comparative results of clinical and immunological studies dealing with the use of the physiological reparation regulators (the human amniotic membrane and systemic enzyme therapy) and the antimetabolite 5-fluorouracil (5-FU) to prevent excessive ocular tissue scarring. The clinical observations have demonstrated the high efficiency of the proposed methods for the physiological regulation of reparative processes as compared with the use of 5-FU, which manifested as a more marked normalization ofophthalmotonus and fewer numbers of postoperative complications. The investigation of the study of proliferation-activating cytokine (TGF-beta1) and antiprolerative cytokine (IFN-gamma) has demonstrated the immunomodulating properties of the physiological reparation regulators used in the present study.

The so-called nonpenetrating surgeries have been, during the recent years, used on an expanding basis in patients with open-angle glaucoma. The paper focuses on their evolution from sinusotomy, suggested by M.M. Krasnov in 1962, to different variations of temporal-canal-stomy. Efficiency of the penetrating and nonpenetrating surgeries is comparatively analyzed; their possible action mechanisms are elucidated.

The paper contains the results of examinations of hemodynamics of the eye and brain in patients with primary open-angle glaucoma (POAG) obtained by the authors also by means of rheoophthalmography made to determine the functional status of intraocular vessels. New methods are suggested for diagnostic interpretation, which enhance the importance of rheography in examinations of hemodynamics of the eye and brain in patients with glaucoma. The authors used self-learning artificial neuron networks to process Fourie- and wavelet factors, obtained in novel rheoophthalmograms processing, which made it possible to recommend the described method for an early diagnosis of POAG.

Trabeculodialysis, a new antiglaucoma surgical technique, developed at the Chair for Ophthalmic Diseases of the Yaroslavl Medical Institute, is described. Trabeculodialysis is aimed at recovery of intraocular fluid discharge via Schlemm's channel and then through orifices into intra- and episcleral vessels; this technique is indicated for patients with open-angle glaucoma in trabecular form of retention. Since 1990 this operation was performed in 50 glaucoma patients. The results will be presented in another paper.