https://doi.org/10.30702/Ophthalmology31032021-12.1.85-96/616.379
УДК 617.7-007.681:616.379-008.64

Gudzenko K. A.

Donetsk National Medical University, Liman, Ukraine

Abstract
 AbstractCommon mechanisms of pathogenesis of diabetic retinopathy (DR) with type 2 diabetes mellitus (DM2) and glaucoma optic neuropathy (GON) with primary open-angle glaucoma (POAG) involve the possibility of their mutual clinical burden.
The aim. To explore the features of the combination of DR in DM2 and POAG in terms of progression of the stages of the pathological process.
Material and methods. 546 patients were examined (546 eyes): 301 patients (301 eyes) had DM2 and POAG; 164 patients (164 eyes) had DM2 and DR, but did not have POAG; 81 patients (81 eyes) had POAG, but did not have DM2. The DR stage was established according to the American Academy of Ophthalmology classification (2002); POAG stage was determined according to the classification of perimetric changes. Some patients were diagnosed with normal tension glaucoma (NTG; 72 eyes). The DR and GON progression indices in patients with POAG were calculated on the basis of the stage and the duration of the diseases and the patients’ age. The software used for statistical research: MedStat і MedCalc v.15.1 (MedCalc Software bvba).
Results. The DR progression (by the ratio of the DR stage to the duration of the DM2) at various combinations with POAG had no significant differences. It increased only when NTG was combined with DM2. GON progression was higher when POAG was combined with DM2. In case of DM2 combined with POAG, the progression of GON was as follows. In the case of its primary development, it was higher in NTG, and when it was connected to DM2 – in POAG. The disease index (the ratio of the primary disease rate to age) was the highest when DM2 was combined with POAG, which made the progression of GON 1.2 times faster (p=0.001). The duration of comorbidity in the POAG + DM2 group was 3-4 years more than in DM2 + POAG and NTG + DM2 groups (p<0.001). No gender differences in the DR and GON progression were found.
Conclusions. The studied characteristic of the combination of DR with DM2 and POAG revealed complex and ambiguous mechanism of their possible interaction, which dictates the need for further investigation of the mechanisms of their comorbidity.

Keywords: diabetic retinopathy, type 2 diabetes mellitus, primary open-angle glaucoma, comorbidity.