Gowhar Ahmad*

Senior Consultant Ophthalmologist, Florence Hospital and University of Jammu and Kashmir, Jammu and Kashmir, India

*Corresponding Author: Gowhar Ahmad, Senior Consultant Ophthalmologist, Florence Hospital and University of Jammu and Kashmir, Jammu and Kashmir, India.

Received: September 23, 2021; Published: December 27, 2021

Abstract

Primary open-angle glaucoma (POAG) is a chronic progressive optic neuropathy. The expected prevalence of glaucoma in the world in 2020 is about 80 million people, and in 2040 - about 112 million. There are about 1.3 million patients with glaucoma officially registered in the Russian Federation, which is a couple of times less than the permissible calculated indicators. High myopia is relevant in the pathogenesis of glaucoma, especially POAG, although increased IOP remains the main risk factor for this condition.

The goal of the work is to identify risk factors for the development of POAG, early changes in functional tests in students and assess the dynamics of indicators when using fractal photostimulation (FPS) in comparison with patients with POAG.

The study contained searching for references between newly significant risk factors according to ICO and initial changes in functional tests - standard automated perimetry (SAP), assigning FPS according to questionnaire data and degree of refraction violation and estimating the dynamics of these indicators against the background before the treatment of FPS.

The study was conducted in 3 clinical groups: 1 - students with myopia - 24; 2 - 29 patients with POAG; 3 - control of 66 students with myopia. Risk factors for developing glaucoma were studied by questioning. Intraocular pressure (IOP) was evaluated in patients with myopia who were homogeneous by age and gender (ICare TA01i, Eyecare OY tonometer). SAP (SITA-Standard, Humphrey, CarlZeissMeditec, 24-2 and Threshold Center1 AP-5000C Kowa) was performed. The dynamics of the perimety indices Mean Deviation (MD) and Pattern Standard Deviation (PSD) was evaluated before and after the course of ten 10-minute sessions of FPS. Results: risk factors for the development of eye diseases were identified. Participants noted a decrease in subjective eye discomfort after FPS sessions. The level of IOP in students with myopia decreased after mydriasis, which can be explained by the combined effect of the drug phenylephrine hydrochloride and tropicamide. In group 1 IOP was measured before and after ten FPS sessions: in participants with mild myopia IOP of the right eye decreased by an average of 0.42 mm Hg and the left eye by 0.63 mm Hg; with moderate myopia the IOP of the right eye did not change, and the left eye decreased by 0.54 mm Hg. In patients with POAG, a decrease in IOP comprised: in Ia stage 0.75 and 1.00 mm Hg for the right and left eyes accordingly; for IIa stage patients the decline was 1.30 mm Hg gor both eyes; in POAG IIIa pations it was 2.28 and 1.28 mm Hg accordingly. When comparing the perimetric indices before and after treatment with FPS in cases of mild degree myopia, MD increased, on average, by 0.96 dB for both eyes, moderate myopia showed a increase in MD by 0.94 and 1.29 dB for right and left eyes accordingly. In patients with POAG the decline of MD was accounted: in Ia stage 0.11 dB for right eye and 0.25 for left eye; in stage IIa, MD decreased by an average of 1.17 dB for OD and 1.13 dB for OS. The greatest effect was found in the eyes with POAG IIIa, where the average defect in the field of view decreased by 6.39 dB.

Keywords: Fractal Optical Stimulation; Open-angle Glaucoma; Myopia; Perimetric Indices; Risk Factors; ICare Tonometry

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Citation

Citation: Maria A Kovalevskaya., et al. “Risk Factors for POAG in the Diagnosis, Prognosis, and Treatment Effectiveness Assessment" Acta Scientific Ophthalmology 5.1 (2022): 46-57.

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Copyright: © 2022 Maria A Kovalevskaya., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.