Hypotensive therapу of secondary glaucoma in patients with endocrine ophthalmopathy

Abstract

Objective: to evaluate the efficiency of monotherapy and fixed combination therapy of secondary glaucoma (SG) in patients with endocrine ophthalmopathy (EOP).Materials and methods. We examined 145 patients (290 eyes and orbits) with different forms and activity of EOP. Among them, 30 patients (58 eyes and orbits) were diagnosed with ″SG detected for the first time and associated with EOP″ (20 % of the cases).The patients with SG received beta-adrenoblockers (BA) or prostaglandin analogues (PGA) as initial monotherapy. Two weeks later, in the absence of intraocular pressure (IOP) compensation, fixed combinations of beta-blocker/carbonic or anhydrase inhibitor (BB/CAI) or beta-blocker/prostaglandin analogue (BB/ PGA) were prescribed.Results. The PGA monotherapy reduced the IOP level by 29 % compared to the baseline level in 33 % of the cases in increased ophthalmic tonus within Me 27 [26;28] mm Hg. (Wilcoxon test, p = 0.005). In IOP levels over 29 [28;31] mmHg, BB/PGA fixed combination therapy reduced IOP by 33 % from the baseline level.Conclusion. SG monotherapy in patients with EOP is effective in increased IOP within Me 27 [26;28] mmHg. In initial IOP levels higher than 29 [28;31] mmHg, it is expedient to prescribe BB/PGA fixed combination therapy as initial therapy.