glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2023-22-1-42-53glaucoma-434Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESАнатомо-топографические особенности переднего и заднего сегментов глаза при ранних стадиях заболевания первичного закрытия углаAnatomical and topographical characteristics of the eye in the early stages of primary angle closure diseaseКурышеваН. И.KuryshevaN. I.

Д.м.н., профессор, заведующая кафедрой глазных болезней; руководитель консультативно-диагностического отдела.

123098, Российская Федерация, Москва, ул. Живописная, 46, корп. 8

123098, Российская Федерация, Москва, ул. Гамалеи, 15

Dr. Sci. (Med.), Professor, Head of the Academic Department of Ophthalmology; Head of the Consultative and Diagnostic Department

46 Zhivopisnaya St., building 8, Moscow, Russian Federation, 123098

15 Gamalei St., Moscow, Russian Federation, 123098

ШароваГ. А.SharovaG. A.

Шарова Галина Аркадьевна - заведующая диагностическим офтальмологическим отделением.

105118, Российская Федерация, Москва, пр. Буденного, 26, корп. 2

Head of the Diagnostic Ophthalmology Department.

26/2 Budenny Av., Moscow, Russian Federation, 105118

galina.shar@mail.ruМедико-биологический университет инноваций и непрерывного образования ФГБУ ГНЦ РФ «Федеральный биофизический центр им. А.И. Бурназяна» ФМБА России; Центр офтальмологии ФМБА России, ФГБУ ГНЦ РФ «ФМБЦ им. А.И. Бурназяна» ФМБАРоссия1Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan; Ophthalmological Center of the Federal Medical-Biological Agency, Federal Medical Biophysical Center named after A.I. BurnazyanRussian FederationООО «Глазная клиника доктора Беликовой»РоссияOOO Glaznaya klinika doktora BelikovojRussian Federation2023230320232214253Copyright © Курышева Н.И., Шарова Г.А., 20232023Курышева Н.И., Шарова Г.А.Kurysheva N.I., Sharova G.A.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/434ЦЕЛЬ

ЦЕЛЬ. Определить анатомо-топографические особенности переднего и заднего сегментов глаза при первичном закрытии угла (ПЗУ) и сравнить их с таковыми при подозрении на первичное закрытие угла (ППЗУ) и в контроле.

МЕТОДЫ

МЕТОДЫ. Проспективное исследование включало 120 пациентов от 41 до 80 лет (60 глаз — ПЗУ, 30 — ППЗУ, 30 глаз — без офтальмопатологии). Исследуемые параметры включали: сфероэквивалент (СЭ), внутриглазное давление (ВГД), толщину хориоидеи в фовеоле (ТХф), аксиальную длину (AL), глубину передней камеры (ACD), высоту свода хрусталика (LV), кривизну радужки и ее толщину, профиль угла передней камеры (УПК): AOD500, AOD750, TISA500, TISA750.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. ППЗУ отличалась от контроля увеличенными СЭ, LV, ВГД, кривизной радужки, ТХф, уменьшенными ACD, AL, и профилем УПК (AOD500, AOD750, TISA500, TISA750) в вертикальных секторах (все p<0,01), по толщине радужки группы были сопоставимы. ПЗУ отличалась от ППЗУ увеличенными СЭ, LV, ВГД, уменьшенными ACD, AL, AOD500 в верхнем секторе и профилем УПК в нижнем секторе (все p<0,01). Толщина радужки и ее кривизна, а также профиль УПК в верхнем секторе и ТХф были сопоставимы. Определены пороговые значения, отличающие ППЗУ и ПЗУ: LV — 0,656 мм, AOD500 — 0,131 мм, TISA500 — 0,051 мм2, TISA750 — 0,093 мм2 в нижнем секторе, ВГД 21 мм рт.ст. В многофакторной модели с поправками на возраст, пол и AL установлена обратная взаимосвязь толщины радужки с ТХф как при ППЗУ, так и при ПЗУ (все p<0,01), но не в контроле (все p>0,01).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Параметры ЗПЗУ достоверно отличаются от нормы. LV и профиль УПК в нижнем секторе наиболее информативны в дифференциальной диагностике ППЗУ и ПЗУ. Обратная взаимосвязь толщины радужки и хориоидеи позволяет предположить роль сосудистой оболочки в патогенезе ЗПЗУ.

PURPOSE

PURPOSE. To determine the anatomical and topographic features of the anterior and posterior segments of the eye in primary angle closure (PAC) and compare them with those in the primary angle closure suspects (PACs) and in controls.

METHODS

METHODS. This prospective study included 120 patients aged 41 to 80 years (60 eyes — PAC, 30 — PACs, 30 eyes — without ophthalmic pathology). The studied parameters included spherical equivalent (SE), intraocular pressure (IOP), choroidal thickness in the fovea (CTf), axial length (AL), anterior chamber depth (ACD), lens volume (LV), iris curvature and its thickness, anterior chamber angle profile: AOD500, AOD750, TISA500, TISA750.

RESULTS

RESULTS. The PAC eyes differed from the control eyes by increased SE, LV, IOP, iris curvature, CTf, reduced ACD, AL, and the anterior chamber profile (AOD500, AOD750, TISA500, TISA750) in vertical sectors (p<0.01). Iris thickness was comparable between the groups.

The PAC eyes differed from the PACs by increased SE, LV, IOP, reduced ACD, AL, AOD500 in the superior sector, and the profile of the anterior chamber angle in the inferior sector (p<0.01). Iris thickness, its curvature, as well as the profile of the anterior chamber in the upper sector and CTf were comparable.

Threshold values that distinguish the PAC eyes and the PACs were determined: LV — 0.656 mm, AOD500 — 0.131 mm, TISA500 — 0.051 mm2, TISA750 — 0.093 mm2 in the lower sector and IOP 21 mm Hg. In the multifactor model adjusted for age, gender and AL, a negative correlation of iris thickness with CTf was established both in the PAC eyes and the PACs (all p<0.01), but not in the controls (all p>0.01). CONCLUSION. Parameters of the PAC eyes and the PACs significantly differ from the norm. LV and the anterior chamber profile in the inferior sector are the most informative for differentiating the PAC eyes from the PACs. Negative correlation between the iris and the choroidal thickness suggests that the choroid plays a role in the pathogenesis of primary angle closure disease.

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