Zadorozhna A. The effeciacy of a new method of treatment in patients with primary open-angle glaucoma considering the balance of immune status

The object of the study is primary open-angle glaucoma. The purpose is to enhance the effectiveness of primary open-angle glaucoma treatment studying the pathogenesis of violations in pro- and anti-inflammatory cytokines (TNF alfa, IL - 1 beta, IL-4) and circulating immune complex of tear and blood serum as well as local protection factors: (lysozyme, sIgA) and therapeutic correction of the violations. The methods used are optical coherence tomography, critical flicker fusion frequency (CFFF), phosphene electrical frequency threshold (PEFT), immunological methods and statistical analyze. Scientific data on the role of circulating immune complex (CIC) in POAG pathogenesis were expanded. Different degrees of changes in blood serum CIC were detected and the most expressed changes were in stage III disease, indicating the presence of auto-immune process. There were expanded scientific data on unbalance of pro- and anti-inflammatory cytokines which were manifested by increased levels of pro-inflammatory cytokines (TNF alfa, IL - 1 beta, IL-4) and decreased level of anti-inflammatory cytokine (IL-4) which was maximal in stage III (inflammatory process). It was first determined that Lipoflavon and Cycloferon combination in comprehensive treatment improves local and systemic immunity in stage I and II patients. Thus, local protection factor level increased CIC, while TNF alfa, IL - 1 beta concentration decreased and IL-4 of tear and blood serum increased. Scientific data on the effect of immune therapy on the structural and functional parameters of the eye in stage I and II patients were supplemented. Thus, neuroretinal rim volume was stabilized, CFFF was increased and PEFT was decreased. The results have been implemented in clinical practice of Lugansk Eye Disease Regional center, Glaucoma Cabinet in Consultative Policlinic of Aleksandrovskaia Kiev Clinical Hospital. It is used in the educational process at Ophthalmology and Otorhinolaryngology Department at SI "Lugansk State Medical University". The scope of use is medicine and ophthalmology.