glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2023-22-4-68-79glaucoma-491Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSФакторы развития рефрактерной формы первичной открытоугольной глаукомы (часть 2)Factors in the development of refractory primary open-angle glaucoma (part 2)https://orcid.org/0000-0001-9516-7396ФоминН. Е.FominN. E.

Фомин Николай Евгеньевич, врач-офтальмолог, ассистент кафедры офтальмологии

117997, Москва, ул. Островитянова, 1

ophthalmologist, Assistant Professor at the Academic Department of Ophthalmology

1 Ostrovityanova St., Moscow, 117997

nikolay.fomin2608@yandex.ruКуроедовА. В.KuroyedovA. V.

д.м.н., профессор кафедры офтальмологии, ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; начальник офтальмологического центра, ФКУ «ЦВКГ им. П.В. Мандрыка» Минобороны России

117997, Москва, ул. Островитянова, 1

107014, Москва, ул. Б. Оленья, 8А

Dr. Sci. (Med.), Professor at the Academic Department of Ophthalmology, Pirogov Russian National Research Medical University; Head of the Ophthalmology Сenter, Mandryka Military Clinical Hospital

1 Ostrovityanova St., Moscow, 117997

8A, Bolshaya Olenya St., Moscow, 107014

ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; ФКУ «ЦВКГ им. П.В. Мандрыка» Минобороны РоссииРоссияPirogov Russian National Research Medical University; Mandryka Military Clinical HospitalRussian Federation2023071220232246879Copyright © Фомин Н.Е., Куроедов А.В., 20232023Фомин Н.Е., Куроедов А.В.Fomin N.E., Kuroyedov A.V.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/491

Развитие первичной открытоугольной глаукомы (ПОУГ) у пациентов старшей возрастной группы ассоциировано с высоким риском ее рефрактерности, что способствует прогрессированию патологического процесса с возможным инвалидизирующим исходом. Сопутствующая патология также является существенным фактором в формировании ПОУГ, требует тщательной диагностики и осо бого подхода к лечению. ПОУГ является мультифакторной патологией, в лечении которой необходимо учитывать как генетическую предрасположенность, так и общую соматическую патологию и социально-экономические причины. Изучение взаимодействия данных факторов способствует лучшему пониманию причин и процессов, вследствие которых возникает рефрактерная форма ПОУГ. Так, наиболее частыми патологическими состояниями со стороны сердечно-сосудистой системы, влияющими на течение ПОУГ, являются артериальная гипертензия, системная артериальная гипотензия гипотензия, ишемическая болезнь сердца, дисциркуляторная энцефалопатия. Кроме того, на течение болезни значительно влияет наличие у пациентов сахарного диабета, нейродегенеративной патологии и курение. Изучение этих вопросов нашло подтверждение в ряде многоцентровых международных исследований. Особое значение, в силу взаимоисключающих публикаций, носят отдельные социальные факторы. В частности, социально-экономический статус пациентов (например, наличие или отсутствие высшего образования) может играть немаловажную роль в диагностике и прогрессировании заболевания. Детальное рассмотрение вышеперечисленных факторов, их анализ, являются важными для лучшего понимания заболевания и, соответственно, улучшения качества жизни пациентов.

Development of primary open-angle glaucoma (POAG) in older patients is associated with a high risk of its refractoriness, which contributes to the progression of the pathological process possibly leading to a severe disabling complication — blindness. Concomitant pathology also makes a significant contribution to the course of primary open-angle glaucoma and requires a careful approach to diagnosis and management. POAG is a multifactorial pathology, so the treatment plan should take into account both genetic predisposition and general somatic pathology, as well as the socio-economic background. Studying the interaction of these factors contributes to a better understanding of the causes and processes that result in the refractory form of POAG. Specifically, the most common pathologies of the cardiovascular system that affect the course of POAG are arterial hypertension (AH) or hypotension, coronary heart disease (CHD), dyscirculatory encephalopathy (DE). In addition, the course of the disease is significantly affected by diabetes mellitus (DM), neurodegenerative pathologies, and smoking. These findings have been confirmed in a number of international multicenter studies. Certain social factors, however, are of particular importance due to mutually exclusive published findings. Notably, the socioeconomic status of patients (for example, the presence or absence of higher education) also plays an important role in the diagnosis and progression of the disease. Detailed consideration of these factors is extremely important for a better understanding of the disease and, consequently, the improvement of the quality of life of patients.

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