Тherapy Results in Patients with Primary Open Angle Glaucoma and Diabetic Retinopathy

Purpose: efficacy and safety assessment of hypotensive drugs in patients with combined pathology — primary open angle glaucoma (POAG) and diabetic retinopathy (DR).

Methods: Patients with POAG 1, 2, 3 stages comorbid with DR and diabetic macular edema (DME) were alocated into three groups based on the stage of glaucoma and hypotensive therapies. POAG 1 –group treated with selective beta-blockers, POAG 2 — the combination of prostaglandin analogues with selective beta-blockers. In POAG 3 — group used the combination of three IOP-lowering drugs include prostaglandin analogues, selective beta-blockers, and carbonic anhydrase inhibitors. Therapy of DR, DME included three intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors. Visual function, eye hydrodynamics and morphometry of retina and optic disc were evaluated in dynamics.

Results: glaucoma monitoring showed no significant increase in intraocular pressure, positive dynamics of tonography during ranibizumab theraphy with use of hypotensive drugs. Combined therapy in patients with POAG 1, 2 improve the visual acuity and perimetric indices MD, PSD testing by Humphrey Field Analyser, reduce edema in the macula and the optic nerve head according OCT.

Conclusion: the use of ranibizumab in patients with association of primary open-angle glaucoma and DR, DME is effective and safe then the correct selection of hypotensive drugs. 

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