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Purpose. To study the influence of personal protective equipment (PPE) of the respiratory and visual systems on the development and progression of dry eye syndrome (DES) and its relationship with other risk factors for medical workers.Patients and methods. The data of 243 people (male — 22.2 %, female — 77.8 %) were analyzed as part of a multi-center analytical scientific one-step study. Total tear production (Schirmer I test) was studied at the beginning and the end of the working day in persons used PPE of respiratory system (disposable medical face mask, gauze masks or different types of respirators), as well as PPE of the eyes (protective half-closed/closed glasses or protective screens). Risk factors for the development and progression of DES were registered (age, smoking, systemic hormones intake, soft contact lenses), as well as the use of artificial tears.Results. A decrease in the Schirmer I test score at the end of a 7–8 hour work shift was found by an average of 3 mm (from 13 (9; 16) mm to 10 (6; 15) mm, p < 0.001). Statistically significant changes were typical mainly for medical personnel (p < 0.001) with the maximum severity in persons working in outpatient sector. The presence of at least one DES risk factor was found in 30.5 % of patients, two factors — in 3.0 %, and three or more — in 7.0 %. There was no influence of risk factors on the degree of changes in total tear production. Reduced tear production is typical for some PPE of respiratory system (disposable masks and respirators) and the eye (screens and half-closed glasses) (p < 0.001). In people who do not use PPE of the eye, significant changes were detected only in the presence of risk factors.Conclusion. The negative influence of various PPE of the respiratory system and eye on the total tear production was established. The decrease in the results of the Schirmer I test by the end of the working day was 20–25 % of the basic level, regardless of the presence of traditional risk factors for DES. The severity of changes depended on the type of PPE used. The data obtained are particularly relevant during the new COVID-19 coronavirus pandemic and justify the need to establish specific prophylactic measures. One of the possible methods is the preventive use of artificial tears.

ä-ð ìåä. íàóê, ïðîôåññîð êàôåäðû îôòàëüìîëîãèè, íà÷àëüíèê îòäåëåíèÿ 1, 2 Ç.Ì. Íàãîðíîâà-àñïèðàíò, àññèñòåíò êàôåäðû 3 Ç.Ó. Òèáèåâà-àñïèðàíò, âðà÷-îôòàëüìîëîã 2 Å.À. Êðèíèöûíà-êëèíè÷åñêèé îðäèíàòîð 2 Â.Ì. Ñåðãååâà-ñòóäåíò 4

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Aim: to identify certain risk factors and their associations, which determine the prognosis of primary open-angle glaucoma (POAG) in patients with different disease stages. Patients and Methods: the final protocol of this clinical research combines multicenter study included the results of dynamic follow-up of 293 patients (293 eyes) with different stages of POAG. The mean age at the time of diagnosis was 65 (59; 70) years. The duration of verified POAG history was 3 (1; 6) years. Age, medical history, disease stage, IOP levels, IOP-lowering medications, comorbidities, other (social) factors (in total, 23 entities considered potential causes of refractory glaucoma) were investigated. All participants were divided into two groups (non-refractory glaucoma and refractory glaucoma) that included six subgroups according to current guidelines on achieving target IOP in various treatment approaches. Results: at the time of verified diagnosis and final examination of POAG patients, IOP levels were higher in the refractory glaucoma group and patients with advanced glaucoma (p<0.001). The most common risk factors, comorbidities, and other variables characterizing refractory glaucoma were pseudoexfoliative syndrome/PEX (53.5%), pigment dispersion syndrome/PDS (16.7%), dry eye disease/DED (38.6%), high myopia (7.9%), coronary heart disease/CHD (40.3%), smoking (16%), and disability resulting from a general illness (12.6%). The rate of these entities varied from 11.1% to 69.4%, being most common in the refractory glaucoma group. Refractory glaucoma patients had a tendency to a slow return to topical treatment in the early postoperative period after glaucoma surgery, despite the lack of achieving target IOP. Conclusion: our study has demonstrated that IOP levels at the time of verified diagnosis directly correlate with the stage of newly diagnosed glaucoma and IOP levels in the setting of glaucoma treatment and predetermine future refractory disease. Moreover, PEX, PDS, DED, CHD, prior myocardial infarction, and disability resulting from a general illness are additional factors determining POAG resistance to treatment. Keywords: glaucoma, intraocular pressure, refractory, risk factors, progression. For citation: Fomin N.E., Zavadskiy P.Ch., Kuroedov A.V. et al. Risk factors affecting progression and course of primary open-angle glaucoma in patients with different disease stages (multicenter study). Russian Journal of Clinical Ophthalmology. 2022;22(2):80–90 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-80-90.