J.ophthalmol.(Ukraine).2015;4:23-27.
UDC 616.7.-007.681-085.27:577.112.385:617.735/.736-018.82-07 https://doi.org/10.31288/oftalmolzh201542327 THE THICKNESS OF THE RETINAL GANGLION CELLS COMPLEX (GCC) AND NERVE FIBERS IN THE MACULAR AREA IN PATIENTS WITH PRIMARY OPEN-ANGLE GLAUCOMA (POAG) THAT RECEIVED L-ARGININE IN TERMS OF THEIR TREATMENT Gonchar’ E. N.PhD student of the Departmentof Ophthalmology of Kharkiv National Medical University (KNMU) The Departmentof Ophthalmology of Kharkiv National Medical University (KNMU) E-mail: elena.n.gonchar@gmail.com Introduction. In accordance with the contemporary concept, the nature of the glaucomatous damage lies in the accelerated loss of retinal ganglion cells and their axons as optic nerve components, which is associated with the neurons neurotrophic defense reduction, the breach of encephalitic trophic factors transportation to the retinal ganglion cells, as well as with neuroglia involvement, which ensures the optic nerve nutrition. Objective: the study of the thickness of the retinal ganglion cells complex (GCC) and nerve fibers in the macular area in patients with primary open-angle glaucoma (POAG), which received L-arginine in terms of their treatment. Material and Methods: 109 patients (192 eyes) with POAG were examined in terms of the study. The patients’ age ranged from 40 to 87 years. All patients were randomized into two groups: index treatment group and control group. The index group consisted of 60 patients (102 eyes) with POAG, which received L-arginine treatment along with the background therapy (in accordance with our own proposed scheme ? UA 52177 U Ukrainian patent license). The control group consisted of 49 patients (90 eyes) with POAG that received the background therapy. The examination included conventional ophthalmic examination techniques, as well as static computer perimetrium and optical coherence tomography (OCT). Results: It has been established that in patients with POAG that received L-arginine in their treatment, the long-term period stabilization frequency of the nerve fibers average thickness in the macular area was 16% higher than that of the control group (71.6% and 55.6%, respectively), the stabilization frequency of the retinal ganglion cells complex (GCC) average thickness was 23.1% higher than that of the control group (85.3% and 62.2%, respectively), the stabilization frequency of retinal ganglion cells complex (GCC) average thickness in the lower part was 24.6% higher than that of the control group (82.4% and 57.8%, respectively), and the differences were reliable for all parameters (p<0.05). Conclusion: The L-arginine use in the treatment of patients with POAG (primary open-angle glaucoma) contributes to the long-term period stabilization of retinal ganglion cells complex (GCC) average thickness, as well as its thickness in the lower part and the macular area nerve fibers thickness. Keywords: primary open-angle glaucoma, L-arginine, retinal ganglion cells complex (GCC) thickness, nerve fibers thickness in the macular area. References: 1. AkopianVS, Semenova NS, Filonenko IV et al.[The retinal ganglion cells complex (GCC)evaluation in primary open-angle glaucoma]. Oftalmologiya. 2011. 8 (1). p. 20-26. Russian. 2. ZhaboedovGD, Petrenko OV, ParkhomenkoEG.[Improvingthe diagnosisof glaucomaas a result ofin-depthunderstanding of thedisease genesis]. Vestnik oftalmologii. 2008. (1). p. 71-73. Russian. 3. Zavgorodniaia NG, Pasechnikova N.V.Primary glaucoma. New look at theold problem.Zaporozhye: AgencyOrbita-YUG; 2010. 192 p. Russian. 4. KuninVD, RedidAA.[The dynamics ofthe glaucomatous processin patients observing and notobserving the follow-upand treatmentregime].Vestnik oftalmologii. 2013. (2). p. 63-68. Russian. 5. KuryshevaNI. [Secondaryneuroprotectionin terms of glaucoma].Medicaladvice. 2008. (3-4). p. 76-77. Russian. 6. NesterovAP. [Glaucoma: major problems, new opportunities].Vestnik oftalmologii. 2008. (1). p. 3-5. Russian. 7. FlammerJ. Glaucoma. 3rd ed. [Transl. from English] Kovalska M, translator.Lviv:World medicine;2008. 464 p. Ukrainian. 8. Cellerino A, B?hr M, Isenmann S. [Apoptosis in the developing visual system]. Cell. Tissue Res. 2000. 301 (1). p. 53-69. 9. Chuman H, Maekubo T, Osako T et al. [Effects of L-arginine on anatomical and electrophysiological deterioration of the eye in a rodent model of nonarteritic ischemic optic neuropathy]. Jpn. J. Ophthalmol. 2013. 57 (4). p. 402-409. 10. Chuman H, Nao-i N et al. [The effect of L-arginine on intraocular pressure in the human eye]. Curr Eye Res. 2000. 20 (6). p. 511-516. 11. Garas A, Vargha P, Hollo G. [Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma]. Eye (Lond). 2011. 25. p. 57-65. 12. Gramlich OW, Lueckner TC, Kriechbaum M et al. [Dynamics, alterations, and consequences of minimally invasive intraocular pressure elevation in rats]. Invest. Ophthalmol. Vis. Sci. 2014. 55 (1). p. 600-611. 13. Kim NR, Lee ES, Seong GJ et al. [Structure-function relationship and diagnostic value of macular ganglion cell complex measuremen using Fourier-domain OCT in glaucoma]. Invest. Ophthalmol. Vis. Sci. 2010. 51. p. 4646-4651. 14. Liesegang TJ [Glaucoma: changing concepts and future directions]. Mayo Clin. Proc.1996. 71 (7). p. 689-694. 15. Mendrinos E, Petropoulos IK, Mangioris G et al. [Intravitreal l-Arginine injection reverses the retinal arteriolar vasoconstriction that occurs after experimental acute branch retinal vein occlusion]. Exp. Eye Res. 2010. 91 (2). p. 205-210. 16. Nickells RW. [Apoptosis of retinal ganglion cells in glaucoma: an update of the molecular pathways involved in cell death]. Surv. Ophthalmol. 1999. 43 (1). p. 151-161. 17. Rao HL. Babu JG, Addepalli UK et al. [Retinal nerve fiber layer and macular inner retina measurements by spectral domain optical coherence tomograph in Indian eyes with early glaucoma]. Eye (Lond). 2012. 26. p. 133–139. 18. Schulze A, Lamparter J, Pfeiffer N et al. [Diagnostic ability of retinal ganglion cell complex, retinal nerve fiber layer, and optic nerve head measurements by Fourier-domain optical coherence tomography]. Graefes Arch. Clin. Exp. Ophthalmol.2011. 249. p. 1039-1045. 19. Seong M, Sung KR, Choi EH et al. [Macular and peripapillary retinal nerve fiber layer measurements by spectral domain optical coherence tomography in normal-tension glaucoma]. Invest. Ophthalmol. Vis. Sci.2010. 51. p. 1446-1452. |