ПРОЛИФЕРАТИВ ДИАБЕТИК РЕТИНОПАТИЯДА НЕОВАСКУЛЯР ГЛАУКОМАНИ ДАВОЛАШГА ДИФФЕРЕНЦИАЛ ЁНДАШУВ, A DIFFERENTIATED APPROACH TO THE TREATMENT OF NEOVASCULAR GLAUCOMA IN PROLIFERATIVE DIABETIC RETINOPATHY, ДИФФЕРЕНЦИРОВАННЫЙ ПОДХОД К ЛЕЧЕНИЮ НЕОВАСКУЛЯРНОЙ ГЛАУКОМЫ ПРИ ПРОЛИФЕРАТИВНОЙ ДИАБЕТИЧЕСКОЙ РЕТИНОПАТИИ

<jats:p>Relevance. Neovascular glaucoma (NVG) developing secondary to proliferative diabetic retinopathy (PDR) is one of the most severe forms of secondary refractory glaucoma. It is characterized by pronounced retinal ischemia, hypersecretion of vasoproliferative factors, the development of neovascularization of the iris and anterior chamber angle, and a persistent increase in intraocular pressure (IOP). Purpose of the study. To evaluate the use of micropulse cyclophotocoagulation, intravitreal administration of VEGF inhibitors, and panretinal retinal laser photocoagulation in the treatment of neovascular glaucoma associated with proliferative diabetic retinopathy. Materials and methods. A total of 45 patients (45 eyes) with neovascular glaucoma secondary to PDR were observed. Patients were divided into three groups according to the level of IOP, severity of pain syndrome, and degree of neovascularization. Results. A statistically significant reduction in IOP was observed in all groups. Regression of iris rubeosis was noted after intravitreal anti-VEGF injections. The most pronounced effect was achieved with the combination of anti-VEGF therapy followed by panretinal laser coagulation (PRP). Discussion. In cases with normal intraocular pressure, anti-VEGF therapy combined with panretinal laser photocoagulation provided satisfactory clinical outcomes. However, in patients with elevated IOP, anti-VEGF therapy and PRP alone were insufficiently effective. In these patients, the early use of micropulse transscleral cyclophotocoagulation (MP-TSCPC) allowed rapid and relatively safe reduction of IOP.</jats:p>