glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2023-22-3-98-108glaucoma-473Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSОсобенности нарушения толерантности к гипотензивному лечению у пациентов с первичной открытоугольной глаукомой и наследственно отягощенным анамнезом заболеванияSpecific features of impaired tolerance to antihypertensive treatment in patients with primary open-angle glaucoma and a hereditary history of the diseasehttps://orcid.org/0000-0003-2348-4880БулахИ. А.BulakhI. A.

врач-офтальмолог

153021, Российская Федерация, Иваново, ул. Рабфаковская, 30

ophthalmologist

30b Rabfakovskaya St., Ivanovo, 153021

bulakh.ilya@yandex.ruhttps://orcid.org/0000-0001-9606-0566КуроедовА. В.KuroyedovA. V.

д.м.н., начальник офтальмологического отделения; профессор кафедры офтальмологии107014, Москва, ул. Большая Оленья, 8А;

117997, Москва, ул. Островитянова, 1

Dr. Sci. (Med.), Head of the Ophthalmological Department;  Professor at the Academic Department of Ophthalmology

8A Bolshaya Olenya St., Moscow, 107014;

1 Ostrovityanova St., Moscow, 117997

https://orcid.org/0000-0002-4583-6050СелезневА. В.SeleznevA. V.

к.м.н., доцент кафедры оториноларингологии и офтальмологии

153012, Иваново, пр. Шереметевский, 8

Cand. Sci. (Med.), Associate Professor at the Academic Department of Otorhinolaryngology and Ophthalmology

8 Sheremetevskiy Av., Ivanovo, 153012

https://orcid.org/0000-0002-3821-689XНагорноваЗ. М.NagornovaZ. M.

к.м.н., ассистент кафедры оториноларингологии и офтальмологии

153012, Иваново, пр. Шереметевский, 8

Cand. Sci. (Med.), Assistant at the Academic Department of Otorhinolaryngology and Ophthalmology

8 Sheremetevskiy Av., Ivanovo,  153012

ООО Медицинский центр «Ивастрамед»РоссияOOO Meditsinskiy tsentr IvastramedRussian FederationФКУ ЦВКГ им. П.В. Мандрыка Минобороны России; ФГБОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияMandryka Central Clinical Military Hospital; 3Pirogov Russian National Research Medical UniversityRussian FederationФГБОУ ВО «Ивановская государственная медицинская академия» МЗ РФРоссияIvanovo State Medical AcademyRussian Federation20231909202322398108Copyright © Булах И.А., Куроедов А.В., Селезнев А.В., Нагорнова З.М., 20232023Булах И.А., Куроедов А.В., Селезнев А.В., Нагорнова З.М.Bulakh I.A., Kuroyedov A.V., Seleznev A.V., Nagornova Z.M.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/473

В обзоре рассмотрены возможные причины снижения эффективности гипотензивного лечения у пациентов с первичной открытоугольной глаукомой (ПОУГ), наследственный анамнез которых отягощен по данному заболеванию. Приведены примеры клинической практики эффективности и продолжительности антиглаукомной топической терапии, а также отражены механизмы и проявления тахифилаксии и нарушения толерантности у пациентов с ПОУГ. Клинические особенности и характер прогрессирования ПОУГ у пациентов с наследственной предрасположенностью могут находить отражение в раннем снижении эффективности проводимого гипотензивного лечения. Несмотря на ряд современных публикаций, в которых было доказано более агрессивное течение ПОУГ у пациентов с отягощенным семейным анамнезом, на данный момент число таких работ весьма ограничено, а сами они не систематизированы. Это, в свою очередь, не позволяет сделать однозначных выводов относительно особенностей назначаемой гипотензивной терапии. Также в публикации рассмотрены современные аспекты фармакогенетики у пациентов с ПОУГ, дальнейшее развитие которой не только позволит минимизировать нежелательные побочные реакции, но и повысить эффективность медикаментозного гипотензивного лечения. Результаты работ, представленных в обзоре, дают возможность систематизировать имеющиеся данные о нарушениях толерантности к гипотензивной терапии и актуализировать необходимость дальнейших клинических исследований в этой области.

This review considers possible reasons for the decrease in the effectiveness of antihypertensive treatment in primary open-angle glaucoma (POAG) patients with a family history of the disease, presents clinical practice examples of the effectiveness and duration of antiglaucoma topical therapy and the mechanisms and manifestations of tachyphylaxis and tolerance disorders in such patients. Clinical features and the nature of POAG progression in patients with a hereditary predisposition may be reflected in the early decrease in the effectiveness of antihypertensive treatment. In some recent publications the authors proved a more aggressive course of POAG in patients with a family history of the disease, but despite that, such works at the moment are very limited in number and unsystematized. This, in turn, prevents drawing unambiguous conclusions regarding the features of the prescribed antihypertensive therapy. The article also discusses modern aspects of pharmacogenetics in patients with POAG, its further development will help minimize unwanted side effects as well as increase the effectiveness of antihypertensive drug treatment. The results of the work presented in this review allow systematization of the available data on impaired tolerance to antihypertensive therapy and maintain the need of further clinical research in this area.

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