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dc.contributor.advisorLaganovska, Guna-
dc.contributor.authorBaumane, Kristīne-
dc.identifier.citationBaumane, K. 2019. Influence of Primary Open Angle Glaucoma Surgery on Structural and Functional Parameters of the Optic Nerve and Its Association with the Level of Atrial Natriuretic Peptide: Summary of the Doctoral Thesis: Specialty – Medicine. Riga: Rīga Stradiņš University.
dc.descriptionThe Doctoral Thesis was carried out at Rīga Stradiņš University. Defence: at the public session of the Doctoral Council of Medicine on 12 December 2019 at 16.00 in Hippocrates Lecture Theatre, 16 Dzirciema Street, Rīga Stradiņš University.-
dc.description.abstractGlaucoma is a chronic, degenerative, progressive optic neuropathy, that results in dysfunction and loss of retinal ganglion cells, resulting in structural and functional changes specific to glaucoma. In the initial stages of glaucoma, the pathological process is asymptomatic, so patients are often diagnosed late when irreversible functional and structural changes have already developed. In the case of uncompensated intraocular pressure, the progression of glaucomatous neuropathy occurs much faster than in the case of compensated intraocular pressure. In the case of glaucoma, it would be useful to determine additional indicators, which would indicate the progression of the pathological process, the effectiveness of the existing therapy and help to intensify the treatment in time. Aim. To investigate the effect of primary open–angle glaucoma surgical treatment on functional and structural parameters of the eye and to evaluate the role of ANP in the pathogenesis of glaucoma. Methods. The promotion work consists of two separate studies. In the first study, the effect of glaucoma surgical treatment on the functional and structural parameters of the eye in a total of 96 patients (96 eyes) was analyzed. In the second study, the level of NT-proANP in intraocular fluid and blood plasma in 58 (58 eyes) patients following glaucoma surgery were analyzed, and the results were compared with a control group. Results. The mean MD before the surgery was 10.93 ± 4.79 dB, but after the glaucoma surgery, the mean MD decreased to 9.99 ± 4.75 dB (p = 0.0916). A statistically significant improvement was observed in the 4th stage patient group from 14.82 ± 0.29 dB to 13.24 ± 2.75 dB (p = 0.0482). Analyzing the thickness of the retinal nerve layer, the results showed that the mean value of RNFL did not differ statistically significantly in patients before and one month after glaucoma operative therapy. A statistically significant improvement in –the horizontal ratio (p = 0.03) was found after evaluating the cup–to-disc ratio of the optic nerve, but no statistically significant difference was found in the vertical ratio (p = 0.77). By analyzing the concentration of NT–proANP in the anterior chamber fluid, it was significantly higher in glaucoma patients than in cataract patients (0.47 versus 0.09 nmol/L, p = 0.0121), and the difference was also statistically significant comparing different groups of primary open-angle glaucoma stages with a control group (p = 0.0001). When performing ROC curve analysis on NT–proANP level in the anterior chamber fluid, a higher resolution ability compared to NT–proANP level in blood plasma in the case of glaucoma was observed. As a result of ROC curve analysis of NT–proANP in the anterior chamber fluid, AUC was 0.865, sensitivity 88.5 %, specificity 72.7 %, cut–off value 0.075 nmol/L, CI 95 % 0.778–0.947, PPV 0.857 and NPV 0.774 (p < 0,001). Conclusions. The obtained data indicate that one month after the performed glaucoma surgery, an improvement of functional parameters in the 4th stage of glaucoma can be observed. However, in the early stages of glaucoma, no significant influence on functional parameters can be detected. One month after the performed glaucoma surgery, a decrease in the horizontal cup–to–disc ratio can be observed, other structural parameters are not significantly affected. Glaucoma patients have elevated levels of ANP in the anterior chamber fluid. The ANP concentration in the anterior chamber fluid correlates with the glaucoma stage. NT–proANP level has a high–resolution ability in the intraocular fluid for glaucoma with a sensitivity of 88.5 %, specificity 72,7%, and a cut-off value of 0.075 nmol/L. ANP can be promoted as a potential biomarker for primary open-angle glaucoma.-
dc.publisherRīga Stradiņš University-
dc.rightsAttribution-NonCommercial 4.0 International*
dc.subjectMedicine, Specialty – Medicine-
dc.subjectSummary of the Doctoral Thesis-
dc.titleInfluence of Primary Open Angle Glaucoma Surgery on Structural and Functional Parameters of the Optic Nerve and Its Association with the Level of Atrial Natriuretic Peptide. Summary of the Doctoral Thesis-
dc.title.alternativePrimāras atvērta kakta glaukomas ķirurģiskās ārstēšanas ietekme uz redzes nerva strukturālajiem un funkcionālajiem rādītājiem un saistība ar ātrija nātrijurētiskā peptīda līmeni. Promocijas darba kopsavilkums-
Appears in Collections:2015.–2019. gadā aizstāvētie promocijas darbi un kopsavilkumi

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