Bezditko P.A., Ivzhenko L.I. Kharkiv National Medical University, Kharkiv, Ukraine
Summary. Diabetes mellitus (DM) is one of the most common endocrine diseases, can provoke variety of inflammatory diseases of the eyelids, including the dysfunction of the meibomian glands as the main cause of blepharitis.
Purpose. To increase the diagnostic effectiveness of meibomian glands pathology patients with diabetes type 2 by examining the nature of the violation of their functions in these patients.
Material and methods. Fifty six patients with different stages of diabetes mellitus were examined using the special lacrimal tests.
Results. It was revealed that there are the visible difference in rate of meibomian glands disfunction, which allowed to present special tests as diagnostic algorithm of meibomian gland dysfunction for early and right diagnose of these conditions in patients with diabetes type 2.
Conclusion. Proposed quantitative characteristics of suggested tests will help in clinical practice to increase the efficiency of the treatment of eye lids problem and to prevent serious complications in diabetes patients.
1Scientific State Ophthalmology Institute, Almaty, Kazakhstan; 2Burdenko State Medical Academy, Voronezh, Russia; 3Mandryka Medicine and Clinical Center, Moscow, Russia; 4Prof. Basynsky Ophthalmology Center, Ltd., Orel, Russia; 5Ophthalmology Hospital, Shymkent, Kazakhstan; 6State Medical University, Kursk, Russia; 7Bayandin Ophthalmology Hospital, Murmansk, Russia; 8State Medical University, Ufa, Russia; 9Russian Eye and Plastic Surgery Center, Ufa, Russia; 10Region Clinical Hospital № 2, Vladivostok, Russia; 11Voyno-Yasenetsky State Medical University, Krasnoyarsk, Russia; 12Regional Eye Hospital, Bryansk, Russia; 13Filatov City Clinical Hospital № 15, Moscow, Russia; 14Regional Hospital № 1, Novosibirsk, Russia; 15Pirogov Russian National Research Medical University, Moscow, Russia; 16Ophthalmology Hospital № 3, Chelyabinsk, Russia; 17State Medical University, Grodno, Belarus; 18Eye-Microsurgery Clinic «SAIFOPTIMA», Tashkent, Uzbekistan; 19Region Clinical Ophthalmology Hospital, Kazan, Russia; 20Region Ophthalmology Hospital, Gulistan, Uzbekistan; 21«Meditsina» Medical Center, Moscow, Russia; 22Makarov Ophthalmology Clinical Hospital, Krasnoyarsk, Russia; 23Helmgoltz State Ophthalmology Institute, Moscow, Russia; 24Semashko State Ophthalmology Hospital, Moscow, Russia; 25State Medical Academy, Omsk, Russia; 26Ophthalmic Diagnostic Center № 7, Saint-Petersburg, Russia; 27Scientific State Ophthalmology Institute, Moscow, Russia; 28State Hospital, Gomel, Belarus; 29City Government Hospital № 5, Perm, Russia
SUMMARY
Background. Glaucoma treatment cost-effectiveness studies are associated with the primary established risk factor for the disease progression – intraocular pressure level (IOP).
Objective. To study glaucoma treatment cost-effectiveness in patients with moderate and advanced glaucoma changes.
Material and methods. In prospective multicenter clinical-research study which was conducted by 36 investigators in 29 clinical centers from December 2013 to April 2014 the results of treatment of 115 patients (187 eyes) with advanced glaucoma changes were counted. Patients’ mean age was 66.33 ± 0.81 years (M ± σ); 68.00 (61.00; 72.00) (Ме, Q25%; Q75%). IOP-lowering treatment cost and cost-effectiveness were calculated with an adjustment for IOP-level compensation according to the Russian Glaucoma Society guidelines.
Results. Mean cost-effectiveness cost was 13.94 ± 0.66 roubles/day which was comparable to the theoretical cost of treatment but was 32% higher than the price that was actually paid for treatment. For prostaglandin analogues monotherapy and fixed combination of beta-blocker and prostaglandin analogue (BB+PG) the difference between the actual price and cost-effectiveness cost was 44% (8.94 ± 0.45 roubles vs. 12.91 ± 0.99 roubles and 9.69 ± 0.80 roubles vs. 13.92 ± 1.24 roubles respectively). At the same time for betablocker and carbonic anhydrase inhibitor fixed combination (BB+CAI) treatment this difference made up 64% (10.40 ± 1.32 roubles vs. 17.08 ± 2.91 roubles).
Conclusion. It is less expensive to achieve a controlled IOP-level with BB+PG fixed combination treatment compared to BB+CAI fixed combination treatment.