glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”glaucoma-167Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEW OF LITERATUREСосудистая теория патогенеза глаукомной оптиконейропатии: обоснование с позиций анатомии и физиологии глазного кровотока. Часть 1Vascular theory of the glaucomatous optic neuropathy pathogenesis: rationale in terms of ocular blood flow anatomy and physiology. Part 1КурышеваН. И.KuryshevaN. I.

д.м.н., профессор, руководитель консультативно-диагностического отдела

Med.Sc.D., Professor, Head of the Diagnostic Department

e-natalia@list.ruЦентр офтальмологии ФМБА России, Клиническая больница № 86РоссияThe Ophthalmological Center of the Federal Medical and Biological Agency, Clinical Hospital No. 86Russian Federation2017141020171639097Copyright © Курышева Н.И., 20172017Курышева Н.И.Kurysheva N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/167

В обзоре приведены данные анатомии и физиологии глазного кровообращения, имеющие непосредственное отношение к патогенезу глаукомы. Рассмотрены особенность артериального, венозного и капиллярного сосудистого русла глаза. Подчеркнуты различия в кровоснабжении разных отделов зрительного нерва, в частности акцентируется внимание на том, что задние цилиарные артерии (ЗЦА) являются единственным источником питания преламинарного и решетчатого отделов зрительного нерва, а также главным источником питания и ретро- ламинарного отдела. Количество и локализация ЗЦА носят строго индивидуальный характер. Особое внимание уделено ретинальному и хориоидальному кровотоку в сравнительном аспекте и с акцентом на регуляцию этих двух источников кровоснабжения сетчатки и зрительного нерва. Описаны особенности артериол и капилляров сетчатки, а также специфичность капилляров перипапиллярной сети. Приведена характеристика «зон водораздела», наличие которых объясняет особенности дефектов полей зрения при глаукоме. Обсуждаются особенности гематоофтальмического барьера, в частности, роль ретинальных капилляров и пигментного эпителия сетчатки. Подчеркивается, что барьер кровь — зрительный нерв, прочный во всех отделах зрительного нерва, оказывается тем не менее проницаемым в его преламинарном отделе.

 

The review presents data on ocular blood flow anatomy and physiology that is directly related to glaucoma pathogenesis. Specifics of the ocular arterial, venous and capillary vascular bed have been comprehensively examined. Differences in blood supply to different parts of the optic nerve have been pointed out with particular focus on the fact that the posterior ciliary arteries are the only source of blood supply to the prelaminar and lamina cribrosa zones of the optic nerve, as well as the major source of blood supply to the retrolaminar zone. The amount and location of posterior ciliary arteries are individual. Particular attention has been paid to the comparison of retinal and choroidal blood flow with an emphasis on the regulation of these two sources of blood supply to the retina and optic nerve. The characteristic of “watershed areas”, which explain the features of the visual field defects in glaucoma, has been given. Features of the hemato-ophthalmic barrier, in particular the role of retinal capillaries and the retinal pigment epithelium, have been discussed. It is pointed out that the blood-optic nerve barrier, which is strong in all zones of the optic nerve, is nevertheless permeable in the optic nerve’s prelaminar zone.

 

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The authors declare that there are no conflicts of interest present.