[Minoxidil-induced ophthalmic hypertension (case report)]. / Indutsirovannaya minoksidilom oftal'mogipertenziya (klinicheskoe nablyudenie).

This article presents a case of a 31-year-old male patient who presented to the outpatient department of the Krasnov Research Institute of Eye Diseases with complaints of diplopia and increased intraocular pressure (IOP) up to 30 mm Hg. The patient had been using minoxidil topically for androgenic alopecia for 8 years. On examination, mild swelling of the bulbar conjunctiva in the upper fornix was revealed; optical coherence tomography showed thinning of the ganglion cell layer, most likely due to moderate myopia. The patient responded well to discontinuation of minoxidil and topical therapy with prostaglandin analogues. After 4 months, an attempt was made to replace topical hypotensive therapy with carbonic anhydrase inhibitors, but the previous hypotensive regimen had to be resumed due to an increase in IOP. During 10 months of observation, no signs of progression were detected according to optical coherence tomography and static perimetry.

[Structural and functional changes in the retina of patients with primary open-angle glaucoma and compensated intraocular pressure while undergoing retinoprotective therapy]. / Strukturno-funktsional'nye izmeneniia setchatki u patsientov s pervichnoi otkrytougol'noi glaukomoi pri kompensirovannom vnutriglaznom davlenii na fone retinoprotektornoi terapii.

PURPOSE: To evaluate the efficacy and safety of intramuscular Retinalamin for retinoprotection in patients with open-angle glaucoma and normalized intraocular pressure (IOP). MATERIAL AND METHODS: The study included 180 patients (355 eyes) randomized into the main (n=90) and control groups (n=90). The patients of the main group received intramuscular Retinalamin injections; the course was repeated 6 months later. Patient examination was performed at 1, 3, 6, 7, 9 and 12 months. RESULTS: Vision acuity did not change in the main group after the treatment courses (p=0.3732, p=0.6862), nor in the control group (p=0.7751). IOP didn't have significant changes during the whole course of the study neither in the main group (p=0.7632), nor in the control group (p=0.3921). MD index in the main group has increased from -5.52±2.76 to -4.82±2.73 dB (measurements from 6 visits: p=0.0391, p=0.0201, p=0.0302, p=0.3708, p=0.0151, p=0.0353). Control group showed negative MD trend (from -3.51±1.84 to -4.60±2.61 dB; p=0.0012). PSD index has changed from 4.63±1.60 to 4.05±1.43 dB (p=0.0081) in the main group, and from 3.73±1.19 to 4.29±1.53 dB (p=0.0027) in the control group. Average thickness of retinal nerve fiber layer (RNFL) and the volume of neuroretinal rim were stable in both the main (p=0.8039, p=0.9005) and the control groups (p=0.7448, p=0.9620). Ganglion cell complex (GCC) thickness remained stable in the main group (p=0.0377), but has decreased in the control group (p=0.0250). P50 amplitude and latency were stable in the main group (6.54±2.61-6.53±2.64 µV, p=0.0479; 48.39±3.69-50.86±4.09 ms, p=0.0271), while in the control group P50 amplitude has decreased (p=0,0031) and the latency has increased (p=0,0194). In the main group, N95 amplitude has stabilized (p=0.0141) with worsened latency (p=0.0492). N95 amplitude in the control group has worsened (p=0.0195), while latency has stabilized (p=0.3401). CONCLUSION: Systemic use of Retinalamin has significant retinoprotective effect confirmed by the dynamics of morphological and functional parameters in patients with POAG and IOP compensation.

[Hypotensive efficacy of bimatoprost in monotherapy of primary open-angle glaucoma]. / Gipotenzivnaia éffektivnost' bimatoprosta v monoterapii pervichnoi otkrytougol'noi glaukomy.

PURPOSE: To study the effectiveness of monotherapy with bimatoprost in patients with decompensated intraocular pressure (IOP). MATERIAL AND METHODS: 90 patients (132 eyes) with stage I-II glaucoma and decompensated IOP previously treated with timolol, latanoprost and travoprost were included in the study. Average IOP at the beginning of the study was 25.4±2.5 mmHg. All patients had their hypotensive medications substituted by bimatoprost. The patients were examined during the initial appointment, as well as after 4 and 12 weeks. RESULTS: IOP decrease was highest in the group of patients who had been treated with timolol: initially IOP was 26.2±1.8 mmHg, after 4 weeks - 21.0±2.2 mmHg, after 12 weeks - 20.8±1.9 mmHg (p<0.001). The initial IOP of patients who had been treated with latanoprost was 24.8±2.9 mmHg, 21.8±2.4 mmHg after 4 weeks, and 21.6±2.3 mmHg after 12 weeks (p<0.001). Patients who had been treated with travoprost had 25.6±2.2 mmHg initially, 23.0±2.5 mmHg after 4 weeks, and 23.2±2.6 mmHg after 12 weeks (p<0.001). By the end of the study IOP has decreased by 5.4, 3.2 and 2.4 mmHg in the groups of patients who had been treated with timolol, latanoprost and travoprost, respectively. CONCLUSION: Bimatoprost can be used as monotherapy if another hypotensive drug in monotherapy is insufficient for IOP compensation.

[The role of fixed dose combinations in the treatment of primary open-angle glaucoma]. / Rol' fiksirovannykh kombinatsii lekarstvennykh sredstv v lechenii otkrytougol'noi glaukomy.

A great number of patients with primary open-angle glaucoma require combination therapy with several hypotensive drugs of different pharmacological groups to efficiently compensate the intraocular pressure (IOP) and prevent further development of glaucoma. Although glaucoma treatment usually starts with monotherapy, several preparations administered simultaneously have stronger hypotensive effect further increased by their additive action. However, the increased frequency of instillations may lead to drug washout and decreased patient compliance. Fixed dose combinations (FDCs) are a pharmacological form of eye drops that combines two or more active drugs in a single dosage form. The frequency of FDCs administration does not exceed two per day, which is convenient for long-term application and helps improve patient compliance. FDCs tolerability tends to be higher than that of simultaneous instillations of separate monotherapy drugs, while the hypotensive in clinical trials is comparable, in some real practice trials is superior. A review of existing studies showed that FDCs are superior to monotherapy in terms of cost-effectiveness. The use of FDCs was found to be beneficial for glaucoma treatment from the viewpoints of both reaching the target IOP for preserving visual functions in glaucoma patients, and minimizing the long-term treatment costs.

[Latanoprost in hypotensive therapy of glaucoma]. / Latanoprost v gipotenzivnoi terapii glaukomy.

The review presents an analysis of therapeutic effectiveness, safety and pharmacokinetics of latanoprost - the reference representative of the prostaglandin group, summarizes the experience of its clinical use in glaucoma as monotherapy and in combination with antihypertensive drugs of other pharmacological groups, its possible effect on the inflammatory process in the anterior segment of the eye, as well as its probable participation in the development of macular edema. The article also gives a recount of relevant local and systemic adverse events.