glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2024-23-4-60-68glaucoma-545Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSОсновные морфофункциональные корреляции между показателями флюктуаций офтальмотонуса и прогрессированием глаукомной оптической нейропатииMain morphofunctional correlations between indicators of intraocular pressure fluctuations and glaucomatous optic neuropathy progressionhttps://orcid.org/0000-0002-1069-8305АмашоваУ. Л.AmashovaU. L.

Амашова Улькер Лайиговна, ассистент кафедры оториноларингологии и офтальмологии 

153012, Иваново, пр. Шереметевский, 8 

Assistant Professor at the Academic Department of Otorhinolaryngology and Ophthalmology 

8 Sheremetyevskiy Ave., Ivanovo, 153012 

amashovaulker@gmail.comhttps://orcid.org/0000-0002-4583-6050СелезневА. В.SeleznevA. V.

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

153012, Иваново, пр. Шереметевский, 8 

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

8 Sheremetyevskiy Ave., Ivanovo, 153012 

https://orcid.org/0000-0001-9606-0566КуроедовА. В.KuroyedovA. V.

д.м.н., профессор, заведующий кафедрой офтальмологии, начальник офтальмологического центра

117997, Москва, ул. Островитянова, 1 

107014, Москва, ул. Б. Оленья, 8А 

Dr. Sci. (Med.), Professor, Head of the Academic Department of Ophthalmology, Head of the Ophthalmology Сenter

1 Ostrovityanova St., Moscow, 117997 

8A Bolshaya Olenya St., Moscow, 107014 

ФГБОУ ВО Ивановский ГМУ Минздрава РоссииРоссияIvanovo State Medical UniversityRussian FederationКафедра офтальмологии лечебного факультета им. акад. А.П. Нестерова ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава РФ ; ФКУ «ЦВКГ им. П.В. Мандрыка» Минобороны РФРоссияPirogov State National Research Medical University ; Mandryka Central Military Clinical HospitalRussian Federation2024121220242346068Copyright © Амашова У.Л., Селезнев А.В., Куроедов А.В., 20242024Амашова У.Л., Селезнев А.В., Куроедов А.В.Amashova U.L., Seleznev A.V., Kuroyedov A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/545

Согласно утвердившимся данным, именно уровень внутриглазного давления (ВГД) является обоснованным фактором риска развития и прогрессирования первичной открытоугольной глаукомы. Тем не менее, прогрессирование глаукомы на фоне достигнутого т.н. «контролируемого» ВГД, измеренного при традиционной одно-двукратной тонометрии, подтвердили возможность существования иных его характеристик, препятствующих стабилизации глаукомного процесса.

В обзоре резюмированы рутинные и описаны новые технологии мониторинга уровня ВГД. Проанализированы исследования, опровергающие и подтверждающие наличие корреляций между колебаниями ВГД и прогрессированием глаукомной оптиконейропатии. Анализ традиционных и перспективных данных качественноколичественных показателей ВГД позволяет сделать вывод о наиболее информативной его характеристике — флюктуации. Формируется концепция, где главной целью выступает демпфирование модуляций уровня ВГД и достижение его постоянно «стабильных» значений в противовес рутинному снижению количественной характеристики уровня ВГД. Это, в свою очередь, определяет характер прогрессирования заболевания и позволяет оптимизировать схемы лечения первичной открытоугольной глаукомы.

According to established data, intraocular pressure (IOP) level is a substantiated risk factor for the development and progression of primary open-angle glaucoma. However, the progression of glaucoma despite achieving the 'controlled' IOP, as measured by traditional one- or two-time tonometry, has confirmed the possibility of other IOP characteristics that prevent the stabilization of the glaucomatous process.The review summarizes commonly used and describes newly emerging techniques for IOP monitoring, and analyzes studies that refute and confirm the presence of correlations between IOP fluctuations and the progression of glaucomatous optic neuropathy. An assessment of traditional and prospective data on the qualitative and quantitative indicators of IOP allows the conclusion that its most informative characteristic is fluctuation. A concept is formed where the main goal is to dampen modulations in IOP levels and achieve consistently 'stable' values, in contrast to routine quantitative reduction in IOP. This, in turn, determines the nature of disease progression and allows for the optimization of primary open-angle glaucoma treatment regimens.

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