On adequate zones of true intraocular pressure in healthy and glaucoma eyes

Author:

Svetlova O. V.1,Koshits I. N.2,Pankratov R. M.3,Makarovskaya O. V.3,Zaseeva M. V.1

Affiliation:

1. Pavlov First St. Petersburg State Medical University

2. ZAO Piterkom-Seti/MS Konsul'tacionnaya gruppa

3. OOO Oftal'mologicheskaya lazernaya klinika

Abstract

PURPOSE. The study was conducted to reveal using the Ocular Response Analyzer (ORA) the possible ranges of mean values of the “rigidity” and “fluctuation” criteria for fibrous membrane of healthy and glaucoma eyes with consideration of the age periods according to the classification by WHO, and to identify adequate true intraocular pressure (IOP) zones corresponding to these ranges.METHODS. The study consisted of a theoretical analysis of clinical measurements of rigidity and fluctuation of the fibrous membrane, the current level of true IOP and the individual level of IOP calculated in youth using ORA by the method of dynamic diagnosis of Koshitsa-Svetlova, and involved in total 674 healthy and 518 glaucoma eyes from individuals aged 18 to 90 years, who were distributed by age periods according to WHO.RESULTS. A "step pattern" of the distribution of Average values of rigidity and fluctuation in healthy and glaucoma eyes were distributed in a “step pattern”, which made it possible to rank the IOP zones adequately to these steps, taking into account the age periods according to WHO. The following adequate ranges of IOP levels for healthy and glaucoma eyes were identified: low IOP zone (up to 13 mm Hg); medium IOP zone (14–20 mm Hg); elevated IOP zone (21–26 mm Hg); high IOP zone (27–32 mm Hg); IOP subcompensation zone (33–39 mm Hg) and uncompensated IOP zone (≥40 mm Hg). The "steps" of the average values of rigidity, fluctuations, and the IOP ranges adequate to them do not intersect. The current value of the rigidity of the fibrous membrane and the IOP value calculated in youth make it possible to reliably attribute each healthy or glaucoma eye to its individual IOP zone.CONCLUSION. Rigidity of the fibrous membrane consistently determines the level of IOP (p>0.001), while the rigidity and fluctuation of the sclera directly influence its current level. The fundamental criteria — rigidity and fluctuation of the fibrous membrane of the eye — do not depend on the central corneal thickness and objectively determine the current functional state of the fibrous membrane. The ability to objectively and reliably determine whether a healthy or glaucoma eye belongs to its individual IOP zone is particularly important for the polyclinic network. The time such express diagnostics takes is 0.02 seconds.

Publisher

Research Institute of Eye Diseases

Reference44 articles.

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2. Terminology and Guidelines for Glaucoma (3th edition), 2008; Publi-Comm, Savona, Italy.

3. Leydhecker W. The intraocular pressure: Clinical aspects. Ann Ophthalmol 1976; 8:398-399.

4. Koshits I.N., Svetlova O.V. On the physiological essence of intraocular pressure. Part 1. Criteria: IOP, rigidity and fluctuation. Natsional’nyi zhurnal glaukoma 2019; 18(1):59-72. https://doi.org/10.25700/NJG.2019.01.08

5. Svetlova O.V., Ryabtseva A.A., Koshits I.N., Makarov F.N., Guseva M.G., Zaseeva M.V. On the choice of effective strategy and tactics in early diagnosis, prevention and treatment of open-angle glaucoma. Part 1. The state of the issue and the initial prerequisites. Oftalmologichny Zhurnal (Ukraine) 2014; 2(457):118-133. https://doi.org/10.31288/oftalmolzh20142118134

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