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Objective: to determine the efficiency of the treatment for glaucoma and its accompanying costs in patients with II-III stages of open-angle glaucoma. Material and methods. The multicenter study which was conducted by 35 investigators in 29 clinical centers in 4 CIS countries from December 2013 to April 2014 took into account the results of the treatment of 115 patients (187 eyes) with glaucoma. The cost and «cost-effectiveness» of the intraocular pressure (IOP)-lowering treatment were calculated with the account of IOP-level compensation. Results. The average cost-effectiveness was 13.94 ± 0.66 rubles/day, which was comparable to the theoretical cost of the treatment but 32 % exceeded the price that patients actually paid for the treatment. As for the monotherapy with prostaglandin preparations and the fixed combination of beta-adrenoblocker and prostaglandin analogue (BB + PG), the difference between the actual price and cost-effectiveness was 44 %. At the same time, this difference in the application of the fixed combination of beta-adrenoblocker and carbonic anhydrase inhibitor (BB + CAI) made up 64 %. Conclusion. It is cheaper to achieve a controlled IOP level in the application of the fixed combination BB + PG compared to the BB + CAI fixed combination treatment.

Introduction. For the past several decades, there has been a discussion as to whether elevated intraocular pressure is just ocular hypertension in a healthy eye, or a sign of glaucoma. Objective. To study the IOP values in patients with primary open-angle glaucoma at the beginning of the study and to correlated them with the disease progression and to determine optimal IOP levels. Material and methods. The final protocol included data from 812 right eyes of 637 glaucoma patients and 175 healthy subjects; the latter formed the control group. The mean age of examined patients was 71.8 ± 0.28 years; 72.00 (66.00; 77.00). Mean disease duration in glaucoma patients was 5.41 ± 0.17 years. The following parameters were assessed: visual acuity, clinical refraction, IOP level by Maklakov tonometry, central corneal thickness and IOP-lowering medication use. Results. In the age group - between 60 and 69 y.o., the IOP level in patients with advanced glaucoma was significantly higher than in patients with moderate glaucoma and healthy subjects. There was no significant difference in central corneal thickness either between glaucoma patients and healthy subjects (both male and female) or between glaucoma patients with different glaucoma changes. The IOP level was higher in patients treated with non-fixed combination of beta-blockers (BB) and prostaglandins (PG) regardless of the disease stage. According to the common standards the IOP level was found to be controlled in 69.93 % of patients with moderate glaucoma and 14.42 % of patients with advanced glaucoma. Conclusion. The results of the study could be used as clinical guidelines for determination of the optimal IOP range, choosing the optimal IOP-lowering medication(s) for starting therapy and during the follow-up in patients with moderate and advanced glaucoma stages.

A study of cross-impact degree and morpho-functional correlation characteristics of primary open angle glaucoma and age-related macular degeneration was performed at 25 clinical sites in Russia and some CIS countries from January through May 2013. The study final protocol included 87 patients (108 eyes) divided into two groups, mean age of patients was 66.6 ± 5.65 years (min 55; max 81). Intragroup and intergroup variance analysis did not establish any significant difference in the macular area between the «glaucoma» group and the «glaucoma + AMD» group depending on the disease stage. The findings suggest that macular degeneration develops subsequent to a preexisting glaucomatous state.

Изучить клинико-эпидемиологические характеристики развития и прогрессирования первичной открытоугольной глаукомы (ПОУГ) у пациентов, которым была выполнена синусотрабекулэктомия.Материал и методы. Проанализированы результаты комплексного клинического обследования и лечения 184 пациентов (73 женщины, 79 глаз; 111 мужчин, 124 глаза) с различными стадиями ПОУГ. Средний возраст пациентов составил 67,96 ± 9,8 лет (женщины – 67,9 ± 8,94 лет, мужчины – 67,94 ± 10,35 лет), p > 0,05. Исследованию был подвергнут анамнез, офтальмологический статус, гипотензивный режим, сопутствующая патология, непосредственные и отдаленные результаты синусотрабекулэктомии.Анамнез болезни от момента установления диагноза до финального исследования составил 5,39 ± 4,87 лет. Пациенты с начальной глаукомой болели 7, 2 ± 3,8 лет, с развитой – 6,5 ± 5,95 лет, с далеко зашедшей – 3,8 ± 3,6 лет. Продолжительность периода наблюдения от момента установления диагноза до проведения операции составила 2,5 ± 3,02 лет. Период наблюдения после выполнения операции составил 2,97 ± 3,93 лет.На момент постановки диагноза ПОУГ в развитой и далеко зашедшей стадиях была выявлена у 80,3 % пациентов, в конце исследования их доля увеличилась до 86,2 % (p < 0,05). После операции гипотензивные назначения не использовали 42,9 % больных с начальной глаукомой, 58,2 % пациентов со II стадией и 47,8 % пациентов с далеко зашедшей глаукомой. Основным показанием к проведению оперативного лечения в 58,62 % стал повышенный уровень внутриглазного давления.Более половины оперированных пациентов (50,74 %) при сроке наблюдения 2,97 ± 3,93 лет не нуждаются в антиглаукомной гипотензивной терапии. Хирургическое лечение глаукомы является эффективным способом лечения заболевания, позволяющим замедлить прогрессирование ГОН.

In order to assess the role of apoptosis in pathogenesis of primary open-angle glaucoma (POAG) apoptosis markers were studied in blood serum and tear fluid of patients with or suspected to have different stages glaucoma. To date the study of POAC pathogenesis goes along with search of possible ways of pharmacotherapy, neuroprotection is considered to be a promising option. Dynamics of sFas/Apo-1 and sFasL as the markers of Fas-mediated apoptosis was studied during treatment. We used nootropic citicoline as a neuroprotector. The markers were studied using enzyme immunoassay. The results show association of POAG onset and progression with interruption of Fas-mediated apoptosis, indicated by the level and proportion of sFas/Apo-1 and sFasL in tear fluid and in a less degree in blood serum. Characteristic features are detected in Fas/FasL system associated with glaucoma stage and correlating with some clinical and functional parameters (perimetry) that is important for understanding of POAG pathogenesis and for prognosis of disease course.