[Neuroprotective therapy in advanced primary open-angle glaucoma]

This study aimed to assess the changes in structural and functional characteristics of the visual analyzer in patients with advanced primary open-angle glaucoma (POAG) in the course of long-term regular use of Retinalamin (Geropharm, Russia).

The study was conducted from 2022 to 2024 at two clinical centers: the M.M. Krasnov Research Institute of Eye Diseases and the Chelyabinsk Glaucoma Center. This multicenter cohort prospective study examined the structural and functional parameters of the visual analyzer in patients with advanced POAG during long-term regular use of Retinalamin.

The study included a total of 56 patients (98 eyes) divided into two groups. The observation group comprised patients with advanced glaucoma who regularly received 10 intramuscular injections of Retinalamin 5 mg (Geropharm, Russia) diluted in 1.0 mL of 0.9% sodium chloride solution in outpatient setting once every three months over a two-year period. The control group consisted of patients with advanced glaucoma who did not receive neuroprotective therapy.

At baseline, all patients in both groups had achieved target intraocular pressure (IOP) through surgical and/or medical treatment, which remained stable throughout the follow-up period.

The mean deviation (MD) decreased by 0.98 (0.78; 1.76) dB/year in the observation group and by 1.65 (0.59; 1.79) dB/year in the control group. The pattern standard deviation (PSD) increased by 0.02 (-0.3; 1.2) dB/year in the observation group and by 0.3 (0.7; 1.3) dB/year in the control group. Mean retinal nerve fiber layer (RNFL) thickness showed a similar trend. Following repeated courses of Retinalamin therapy, the observation group demonstrated stable, minimal decrease in RNFL thickness amounting to 1.5 (-0.25; 5.0) μm/year. The control group exhibited more pronounced decrease in RNFL thickness averaging 3.0 (0.75; 10.2) μm/year.

Long-term neuroretinoprotective therapy with Retinalamin (Geropharm, Russia) in patients with advanced POAG is justified when administered regularly and the intraocular pressure is stable and well controlled.