Glaucoma and Diabetic Retinopathy in patients with diabetes mellitus type 2. Review.

Glaucoma and diabetic retinopathy (DR) are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics are optical coherence tomography and Heidelberg retina tomography. They give an opportunity to estimate the dynamics of pathological process and the efficiency of surgical and pharmacological treatment. Optical scanning of an optic disk and peripapillary retina gives a chance to estimate up to 20 morphometric parameters. Determination of retinal nerve fiber layer (RNFL) thickness in peripapillary zone reflects a condition of nerve fibers and extent of their defeat. It is shown that in glaucoma there is a thinning of RNFL and a neuroretinal rim. In early diagnostics of glaucoma the parameters of optic disk characterizing neuroretinal rim are considered the most informative. OCT considerably expands diagnostic research possibilities of structural and morphological retinal changes in a 
macular zone in patients with DR and DME. Measurement of retinal thickness in macular area is a key point in diagnostics and tactics of treatment. The standard method of DR therapy is retinal laser coagulation. However, laser photocoagulation as monotherapy is not effective enough in patients with diffuse and cystoid macular edema. It is more reasonable to use retinal laser photocoagulation in combination with antiangiogenic therapy for treatment of the diabetic macular edema (DME) and DR. The special emphasis is put on development of treatment algorithm of combination of glaucoma and diabetic retinopathy. Therapy of neovascular glaucoma in patients with diabetes mellitus type 2 is a complex problem. Such patients traditionally get panretinal laser photocoagulation. Recently anti-VEGF-agents are used as additional therapy of neovascular glaucoma. However, nowadays the influence of antiangiogenic treatment on dynamics of clinical and morphological parameters in patients with the combined pathology is insufficiently investigated.

1. Dedov I. I., Mel’nichenko G. A. [Endocrinology. National guideline]. Jendokrinologija. Nacional’noe rukovodstvo. Geotar-Media, Moscow, 2013, 1072 p. (in Russ.).

2. Chen E. Burden of illness of diabetic macular edema: literature review. Current Medical Research and Opinion. 2010; 26 (7):1587‑1597.

3. Egorov E. A. [National guideline of glaucoma under the editorship of E. A. Egorov, second edition]. Nacional’noe rukovodstvo po glaukome pod red. E. A. Egorova, 2‑e izdanie. Моscow, 2013, 824 p. (in Russ.).

4. Gazizova I. R. [World statistics of glaucoma] Mirovaja statistika glaukomy. [Glaucoma news] Novosti glaukomy. 2014; 1: 29. (in Russ.).

5. Alekseev I. B., Moshetova L. K., Vorob’eva I. V. [Medicamentous activation of uveoskleral outflow at patients with glaucoma proceeding against diabetes]. Medikamentoznaja aktivacija uveoskleral’nogo ottoka u pacientov s glaukomoj, protekajushhej na fone saharnogo diabeta. http://www.eyenews.ru / stati97.htm. (in Russ.).

6. Astahov Ju. S., Krylova I. S., Shadrichev F. E. [Is diabetes a risk factor of primary open-angle glaucoma]. Javljaetsja li saharnyj diabet faktorom riska pervichnoj otkrytougol’noj glaukomy. [Clinical ophthalmology]. Klinicheskaja oftal’mologija. 2006; 7 (3): 91‑94. (in Russ.).

7. Lipatov D. V. [Practical guidance for doctors. Ed. I. I.Dedov, M. V. Shestakova]. Diabeticheskaja glaukoma: Prakticheskoe rukovodstvo dlja vrachej pod red I. I. Dedova, M. V. Shestakovoj. Moscow.: Medicinskoe informacionnoe agentstvo, 2013, 192 p. (in Russ.).

8. Vorob’eva I. V., Merkushenkova D. A., Kalinina N. I., Ivanova D. P., Jestrin L. G. [Interrelation between primary open-angle glaucoma and diabetes]. Vzaimosvjaz’ mezhdu pervichnoj otkrytougol’noj glaukomoj i saharnym diabetom. [Glaucoma news]. Novosti glaukomy. 2012; 4 (24): 3‑4. (in Russ.).

9. Stewart M. W. The expanding role of vascular endothelial growth factor inhibitors in ophthalmology. Mayo Clin Proc. 2012; 87 (1):77‑88.

10. Moshetova L. K., Vorob’eva I. V., Parfenova E. V., Merkushenkova D. A., Makarevich P. I., Alehnovich V. I. [Results of influence antiangiogenny therapy on diabetic macular edema at diabetes mellitus type 2 on a clinical, functional and morphological condition of a retina]. Rezul’taty vlijanija antiangiogennoj terapii diabeticheskogo makuljarnogo oteka pri saharnom diabete vtorogo tipa na kliniko-funkcional’noe i morfologicheskoe sostojanie setchatki. [Ophthalmology]. Oftal’mologija. 2013; 10 (1): 1‑6. (in Russ.).

11. Călugăru D., Călugăru M. Neovascular glaucoma-etipathogeny and diagnosis, Oftalmologia. 2012; 56 (2):3‑14.

12. Balashevich L. I., Izmajlov A. S. [Diabetic ophthalmopathy]. Diabeticheskaja oftal’mopatija. Chelovek. St.Petersburg, 2012, 396 p. (in Russ.).

13. Nesterov A. P. [Glaucoma]. Glaukoma. [Medical informational agency]. Medicinskoe informacionnoe agentstvo, Moscow, 2008, 360p. (in Russ.).

14. Kochergin S. A., Vorob’eva I. V., Mihaleva L. G. [Some pathogenetic aspects of diabetic retinopathy at patients with diabetes mellitus type 2]. Nekotorye aspekty patogeneza diabeticheskoj retinopatii u bol’nyh s saharnym diabetom 2 tipa. [The XII All-Russian school of the ophthalmologist the collection of scientific works under the edition of Egorov E. A.]. XII Vserossijskaja shkola oftal’mologa sbornik nauchnyh trudov pod red. Egorova E. A. Мoscow, 2013, pp.182‑185. (in Russ.).

15. Repkina M. Ju. [Prevention of progressing diabetic retinopathy with control of biomarkers metabolic violations]. Profilaktika progressirovanija diabeticheskoj retinopatii s kontrolem biomarkerov metabolicheskih narushenij. [Dis. M. D.] Diss. kand. med. nauk Мoscow, 2010, 182p. (in Russ.).

16. Alekseev I. B., Kochergin S. A., Vorob’eva I. V., Mihaleva L. G. [The role of an oxidizing stress in pathogenetic mechanisms of diabetic retinopathy at diabetes mellitus type 2]. K voprosu o roli okislitel’nogo stressa v patogeneze diabeticheskoj retinopatii pri saharnom diabete II tipa. [Russian journal of ophthalmology]. Rossijskij oftal’mologicheskij zhurnal. 2013; 4: 99‑102. (in Russ.).

17. Optical coherence tomography for age-related macular degeneration and diabetic macular edema: an evidence-based analysis. Health Quality Ontario. Ont Health Technol Assess Ser. 2009; 9 (13):1‑22.

18. Pashtaev N. P., Gorbunova N. Ju., Pozdeeva N. A., Artem’eva T. F. [Possibilities of an optical coherence tomography in diagnostics and treatment of glaucoma]. Vozmozhnosti opticheskoj kogerentnoj tomografii v diagnostike i lechenii glaukomy. [Materials of the 4th International conference Glaucoma: theories, tendencies, technologies. HRT Russia Club — 2006: Collection of articles under the edition of A. P. Nesterov]. Materialy IV Mezhdunarodnoj konferencii Glaukoma: teorii, tendencii, tehnologii. HRT Klub Rossija — 2006: Sb. nauchn. st. pod red. A. P. Nesterova, Мoscow. 2006, pp. 271‑276. (in Russ.).

19. Gonzalez-Garcia A. O., Vizzeri G., Bowd C., Medeiros F. A., Zangwill L. M., Weinreb R. N. Reproducibility of RTVue retinal nerve fiber layer thickness and optic measurements. Am. J. Ophthalmol. 2009;147:1067‑1074.

20. Kuroedov A. V., Ogorodnikova V. Ju., Romanenko I. A. [Characteristics of structurally functional changes of the visual analyzer of patients with glaucoma against carriedout treatment]. Harakteristiki strukturno-funkcional’nyh izmenenij zritel’nogo analizatora bol’nyh glaukomoj na fone provodimogo lechenija. [Oftalmol. Sheets]. Oftal’mol. vedomosti. 2009; 1: 38‑50. (in Russ.).

21. Strahov V. V., Alekseev V. V., Ermakova A. V. [Analysis of Optic Nerve Head and retina biometric Parameters for early diagnostics of primary glaucoma]. Informativnost’ bioretinometricheskih pokazatelej diska zritel’nogo nerva i setchatki v rannej diagnostike pervichnoj glaukomy. [Glaucoma]. Glaukoma. 2009; 3: 3‑10. (in Russ.).

22. Shevchenko M. V., Shahalova A. P., Shugurova N. E. [Optical coherence tomography in early diagnostics and monitoring of glaucoma: comparison of informational content of morphometric parameters]. Opticheskaja kogerentnaja tomografija v rannej diagnostike i monitoringe glaukomy: sravnenie informativnosti morfometricheskih parametrov. [Materials of the eleventh International congress Glaucoma: theories, tendencies, technologies.. HRT / Spectralis Russia Club — 2013: Collection of articles under the edition of the prof. E. A. Egorov, the prof. Yu. S. Astakhov and the prof. V. P. Erichev]. Materialy XI Mezhdunarodnogo kongressa Glaukoma: teorii, tendencii, tehnologii. HRT / Spectralis Klub Rossija — 2013: Sb. nauchn. st. Pod red. prof. E. A. Egorova, prof. Ju. S. Astahova i prof. V. P. Ericheva. Moscow. 2013, pp. 271‑275. (in Russ.).

23. Shakalova A. P. [Quantitative Analysis of neuroretinal rim parameters at various stages of primary open-angle glaucoma according to an optical coherence tomography]. Kolichestvennaja ocenka parametrov nejroretinal’nogo pojaska pri razlichnyh stadijah pervichnoj otkrytougol’noj glaukomy po dannym opticheskoj ogerentnoj tomografii. [Materials of the 8th International congress Glaucoma: theories, tendencies, technologies. HRT Russia-2010 Club]. Materialy VIII Mezhdunarodnogo kongressa Glaukoma: teorii, tendencii, tehnologii. HRT Klub Rossija-2010. Moscow. 2010, pp. 401‑404. (in Russ.).

24. Chang R. T., Knight O. J., Feuer W. J., Budenz D. L., Sensitivity and specificity of timedomain versus spectral-domain optical coherence tomography in diagnosing early to moderate glaucoma.Ophthalmology. 2009; 116 (12): 2294‑2299.

25. Krjachko N. S., Ivanchenko O. V., Pureskin N. P., Nikitina I. V., Migal’ S. F., Migal’ D. S. [Structural and functional changes of retina and optic nerve at primary open-angle glaucoma]. Strukturnye i funkcional’nye izmenenija setchatki i zritel’nogo nerva pri pervichnoj otkrytougol’noj glaukome. [Materials of the 11th International congress Glaucoma: theories, tendencies, technologies. HRT / Spectralis Russia-2013 Club: Collection of articles under the edition of the prof. E. A. Egorov, the prof. Yu. S. Astakhov and the prof. V. P. Erichev]. Materialy XI Mezhdunarodnogo kongressa Glaukoma: teorii, tendencii, tehnologii. HRT / Spectralis Klub Rossija — 2013: Sb. nauchn. st. Pod red. prof. E. A. Egorova, prof. Ju. S. Astahova i prof. V. P. Ericheva. Moscow. 2013, pp. 177‑181. (in Russ.).

26. Jarcev A. V., Strahov V. V., Alekseev V. V., Hljaf V. B. [Research of external layers of retina at patients with primary glaucoma]. Issledovanie naruzhnyh sloev setchatki u pacientov s pervichnoj glaukomoj. [Glaucoma news]. Novosti glaukomy. 2014; 1: 3‑5. (in Russ.).

27. Risović D., Gvozdenović R., Marjanović I., Abazi Z., Stamenković M. Heidelberg Retina Tomography II parameters in evaluating high- and normal-pressure glaucomaprogression. Vojnosanit Pregl. 2014;71 (4):341‑5.

28. Iester M., Mariotti V., Lanza F., Calabria G. The effect of contour line position on optic nerve head analysis by Heidelberg Retina Tomograph. Eur J Ophthalmol. 2009; 19 (6): 942‑948.

29. Yang B., Ye C., Yu M., et al. Optic disc imaging with spectral domain optical coherence tomography: variability and agreement study with Heidelberg retinal tomography. Ophthalmology.2012; 119 (9): 1852‑1857.

30. Golubina L. A., Harinceva S. V., Zimina M. G., Derevcova K. A. [The comparative analysis of morphometric indicators of optic nerve head at patients with primary openangle glaucoma according to optical coherence tomography and HRT]. Sravnitel’nyj analiz morfometricheskih pokazatelej diska zritel’nogo nerva u pacientov s pervichnoj otkrytougol’noj glaukomoj po dannym opticheskoj kogerentnoj omografii i retinal’noj tomografii. [Annals of Ophthalmology]. Vestnik oftal’mologii. 2 012; 4 : 32‑34. (in Russ.).

31. Shpak A. A., Sevost’janova M. K., Ogorodnikova S. N., Usol’ceva E. A. [Assessment of stereometric parameters of optic nerve head and retinal nerve fiber layer by the HRT III device. Message 4. Comparison of an error of the Heidelberg retinotomography and spectral optical coherence tomography at an assessment of characteristicss of an optic nerve head]. Ocenka stereometricheskih parametrov diska ritel’nogo nerva i sloja nervnyh volokon setchatki na pribore HRT III. Soobshhenie 4. Sravnenie oshibki metodov gejdel’bergskoj retinotomografii i spektral’noj opticheskoj kogerentnoj tomografii pri ocenke parametrov diska zritel’nogo nerva. [Glaucoma].Glaukoma. 2013; (4): 11‑20. (in Russ.).

32. Hwang D. J., Lee E. J., Lee S. Y., Park K. H., Woo SJ. Effect of Diabetic Macular Edema on Peripapillary Retinal Nerve Fiber Layer Thickness Profiles.Invest Ophthalmol Vis Sci. 2014.13‑13776.

33. Bojko Je. V., Sosnovskij S. V., Berezin R. D. [Antiangiogenic therapy in ophthalmology]. Antiangiogennaja terapija v oftal’mologii. VMedA im. S. M. Kirova. St.Petersburg. 2013, 292 p. (in Russ.).

34. Balashevich L. I., Gacu M. V., Chizh L. V. [Research of the results of microphotocoagulation of diabetic macular edema depending on the initial volume of retina]. Issledovanie rezul’tatov mikrofotokoaguljacii diabeticheskogo makuljarnogo oteka v zavisimosti ot ishodnogo ob’ema setchatki. [Collection of articles: Modern technologies of vitreoretinopathy treatment-2011]. Sb. nauchn. Trudov: Sovremennye tehnologiii lechenija vitreoretinal’noj patologii-2011. Мoscow. p.37‑42. (in Russ.).

35. Michaelides M, Kaines A, Hamilton RD, et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT study): 12‑month data: report 2. Ophthalmology. 2010;117:1078‑86.

36. Keane P. A., Sadda S. R. Development of Anti-VEGF Therapies for Intraocular Use: A Guide for Clinicians. J Ophthalmol. 2012;2012:483034.

37. Claudia Krispel, Murilo Rodrigues, Xiaoban Xin. Ranibisumab in diabetic macular edema. World J Diabetes.2013; 4 (6): 310‑318.

38. Miller J. W., Le Couter J., Strauss E. C., Ferrara N. Vascular endothelial growth factor a in intraocular vascular disease. Ophthalmology. 2013;120:106‑114.

39. Sultan M. B., Zhou D., Loftus J., Dombi T., Ice K. S. A phase 2 / 3, multicenter, randomized, double-masked, 2‑year trial of pegaptanib sodium for the treatment of diabetic macular edema.Ophthalmology. 2011;118: 1107‑1118.

40. Stefanini F. R., Arevalo J. F., Maia M. Bevacizumab for the management of diabetic macular edema.World J Diabetes. 2013;4 (2):19‑26.

41. Diabetic Retinopathy Clinical Research Network. Elman MJ, Aiello LP, Beck RW, et al. Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2010;117:1064‑77.

42. Lüke J., Nassar K., Lüke M., Grisanti S. Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma-results from a prospective interventional case series, Graefes Arch Clin Exp Ophthalmol. 2013; 251 (10):2403‑2413.

43. Botabekova T. K., Kanaf’janova Je.G., Aldasheva N. A., Al’ — Astal’ M. S., Zhurgumbaeva G. K., Odincov K. V., Abysheva L. D. [The first experience of using VEGF-inhibitor Lucentis in treatment of ophthalmologic complications of diabetes mellitus]. Pervyj opyt primenenija ingibitora VEGF Lucentisa v lechenii oftal’mologicheskih oslozhnenij saharnogo diabeta. [Clinical ophthalmology]. Klinicheskaja oftal’mologija. 2011; 12 (3): 92‑94. (in Russ.).

44. Belyj Ju. A., Tereshhenko A. V., Molotkova I. A. [Anti-VEGF-agents in treatment of neovascular glaucoma]. Primenenie anti-VEGF-preparatov v lechenii neovaskuljarnoj glaukomy. [Collection of articles. ophthalmosurgical conference with the international participation «East-West»]. Sbonik nauch.trudov nauch.‑prakt. Konf. Po oftal’mohirurgii s mezhdunarodnym uchastiem «Vostok-Zapad». Ufa, 2011, p.171‑173. (in Russ.).

45. Bikbov M. M., Babushkin A. Je., Orenburkina O. I. [Anti-VEGF-agents in treatment of neovascular glaucoma]. Primenenie anti-VEGF-preparatov v lechenii neovaskuljarnoj glaukomy. [Annals of ophthalmology]. Vestnik oftal’mologii. 2012; 5: 50‑53. (in Russ.).

46. Pershing S., Bakri S. J., Moshfeghi D. M. Ocular hypertension and intraocular pressure asymmetry after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2013;44 (5):460‑4.

47. Loukianou E., Brouzas D., Apostolopoulos M. Sustained ocular hypertension following intravitreal injections of 0.5 mg / 0.05 ml ranibizumab. Int Ophthalmol. 2011;31 (3): 211‑3.

48. Good T. J., Kimura A. E., Mandava N., Kahook M. Y., Sustained elevation of intraocular pressure after intravitreal injections of anti-VEGF agents. Br J Ophthalmol. 2011;95 (8):1111‑1114.

49. Höhn F., Mirshahi A., Impact of injection techniques on intraocular pressure (IOP) increase after intravitreal ranibizumab application. Graefes Arch Clin Exp Ophthalmol. 2010; 248 (10):1371‑1375.

50. Frenkel M. P., Haji S. A., Frenkel R. E. Effect of Prophylactic Intraocular Pressure — Lowering Medication on Intraocular Pressure Spikes After Intravitreal Injections. Arch Ophthalmol. 2010;128 (12):1523‑1527.

51. El Chehab H., Le Corre A., Giraud J. M., Ract-Madoux G, Swalduz B., Dot C. Efficacy of prophylactic treatment of intraocular pressure spikes due to intravitreal injections, J Fr Ophtalmol. 2012;35(8):614‑621.