[Ocular hypotensive effect of systemic beta-blockers in patients with primary glaucoma and arterial hypertension]. / Oftal'mogipotenzivnyĭ éffekt sistemnogo primeneniia beta-blokatorov pri pervichnoĭ glaukome i arterial'noĭ gipertenzii.

AIM: to evaluate the ocular hypotensive efficacy of systemic beta-blockers in primary glaucoma patients suffering from arterial hypertension (AH). MATERIAL AND METHODS: The study included 29 patients with POAG (58 eyes) aged from 47 to 83 years. Patients with stage I-III POAG received instillations of prostaglandin analogs and carbonic anhydrase inhibitors. All POAG patients also suffered from arterial hypertension and were prescribed selective beta-blockers (metoprolol, bisoprolol, or nebivalol) as monotherapy or as part of combination therapy (if the target arterial pressure had not been achieved under the initial treatment). After the start of oral beta-blockers therapy, the patients were re-examined at 2 and 4 weeks, 3 months, 6 months, and 1 year. RESULTS: A clinically significant reduction of IOP in the most seriously affected eye - by 3.3 mmHg (p<0.05), or 14% - occurred four weeks after the start of selective beta-blockers. Over three months of combination therapy, IOP in the 'worst' eye decreased by 4.4 mmHg (18.5%). At 1 year, IOP in the 'worst' eye was 6.2 mmHg (26%) lower than at baseline (p<0.05). CONCLUSION: Aged and senile patients with primary glaucoma usually suffer from polypathy (on average, they have 6.3±0.6 concurrent somatic diseases). To reduce the risk of polypharmacy and the frequency of side effects in the treatment of POAG and AH patients, it is advised that the treatment includes oral selective beta-blockers able to provide target levels of arterial pressure and IOP. In this study, oral beta-blockers in POAG and AH patients enabled IOP reduction as great as 18.5%-26% of baseline values over a 1-year follow-up period.

[Life expectancy of patients with primary glaucoma, residents of a large industrial city of Siberia].

PURPOSE: To investigate life expectancy and the structure of causes of death in patients with primary glaucoma, residents of a large industrial city of Siberia. MATERIAL AND METHODS: The database of the Novokuznetsk Public Health Department information analysis center on registration forms 025 (outpatients) and 066 (inpatients) for 2004-2011 was analyzed. RESULTS: A total of 5424 primary glaucoma patients were registered during 2004-2011, of whom 441 (8.1%) subsequently died. Age at death of patients with primary glaucoma was 69.0 +/- 7.2 years. The difference between age at death and at diagnosis of glaucoma was 2.6 +/- 1.8 years. CONCLUSION: The correlation suggests that primary glaucoma is a predicting factor for vascular events, such as stroke or myocardial infarction. The authors assume that topical administration of beta blockers without consulting a physician and/or a cardiologist may lead to ischemic stroke.