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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">glaucoma</journal-id><journal-title-group><journal-title xml:lang="ru">Национальный журнал Глаукома</journal-title><trans-title-group xml:lang="en"><trans-title>National Journal glaucoma</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-4104</issn><issn pub-type="epub">2311-6862</issn><publisher><publisher-name>Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.53432/2078-4104-2025-24-3-76-88</article-id><article-id custom-type="elpub" pub-id-type="custom">glaucoma-587</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW OF LITERATURE</subject></subj-group></article-categories><title-group><article-title>Современные представления о роли биомеханических факторов в патогенезе и диагностике глаукомы нормального давления</article-title><trans-title-group xml:lang="en"><trans-title>Current concepts of the role of biomechanical factors in the pathogenesis and diagnosis of normal-tension glaucoma</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9356-6526</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Арутюнян</surname><given-names>Л. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Arutyunyan</surname><given-names>L. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор кафедры офтальмологии, заведующая диагностическим отделением </p><p>125993, Москва, ул. Баррикадная, 2/1, стр.1</p><p>123557, Москва, ул. П. Осипенко, 10, к. 1</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor at the Academic Department of Ophthalmology, Head of the Diagnostics Department</p><p>2/1 Barricadnaya St., Moscow, 125993</p><p>10 Bld. 1 Poliny Osipenko St., Moscow, 123007</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0562-5440</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анисимова</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Anisimova</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, врач-офтальмолог, генеральный директор </p><p>123557, Москва, ул. П. Осипенко, 10, к. 1</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor, ophthalmologist, Director </p><p>10 Bld. 1 Poliny Osipenko St., Moscow, 123007</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1922-4939</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анисимов</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Anisimov</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор кафедры глазных болезней, научный директор </p><p>127006, Москва, ул. Долгоруковская, 4</p><p>123557, Москва, ул. П. Осипенко, 10, к. 1</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor at the Academic Department of Eye Diseases, Scientific Director </p><p>4 Dolgorukovskaya St., Moscow, 127006</p><p>10 Bld. 1 Poliny Osipenko St., Moscow, 123007</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-3702-696X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маммадова</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Mammadova</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-офтальмолог, аспирант кафедры офтальмологии </p><p>123557, Москва, ул. П. Осипенко, 10, к. 1</p><p>125993, Москва, ул. Баррикадная, 2/1, стр.1</p></bio><bio xml:lang="en"><p>postgraduate student, ophthalmologist </p><p>2/1 Barricadnaya St., Moscow, 125993</p><p>10 Bld. 1 Poliny Osipenko St., Moscow, 123007</p></bio><email xlink:type="simple">N.Sabina@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-2037-7494</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Братчук</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bratchuk</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-офтальмолог, соискатель кафедры офтальмологии </p><p>123557, Москва, ул. П. Осипенко, 10, к. 1</p><p>125993, Москва, ул. Баррикадная, 2/1, стр.1</p></bio><bio xml:lang="en"><p>ophthalmologist, candidate student </p><p>10 Bld. 1 Poliny Osipenko St., Moscow, 123007</p><p>2/1 Barricadnaya St., Moscow, 125993</p></bio><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ДПО РМАНПО Минздрава РФ ; ООО Глазной центр «Восток-Прозрение»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education ; OOO Glaznoy Centr Vostok-Prozrenie</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ООО Глазной центр «Восток-Прозрение»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>OOO Glaznoy Centr Vostok-Prozrenie</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Российский университет медицины» Минздрава России ; 127006, Москва, ул. Долгоруковская, 4</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian University of Medicine ; OOO Glaznoy Centr Vostok-Prozrenie</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ООО Глазной центр «Восток-Прозрение» ; ФГБОУ ДПО РМАНПО Минздрава РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education ; OOO Glaznoy Centr Vostok-Prozrenie</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ООО Глазной центр «Восток-Прозрение» ; ФГБОУ ДПО РМАНПО Минздрава РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>OOO Glaznoy Centr Vostok-Prozrenie ; Russian Medical Academy of Continuous Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>13</day><month>09</month><year>2025</year></pub-date><volume>24</volume><issue>3</issue><fpage>76</fpage><lpage>88</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Арутюнян Л.Л., Анисимова С.Ю., Анисимов С.И., Маммадова С.Ю., Братчук А.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Арутюнян Л.Л., Анисимова С.Ю., Анисимов С.И., Маммадова С.Ю., Братчук А.А.</copyright-holder><copyright-holder xml:lang="en">Arutyunyan L.L., Anisimova S.Y., Anisimov S.I., Mammadova S.Y., Bratchuk A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.glaucomajournal.ru/jour/article/view/587">https://www.glaucomajournal.ru/jour/article/view/587</self-uri><abstract><p>Глаукома нормального давления (ГНД) является сложной формой первичной открытоугольной глаукомы, при которой прогрессирующее повреждение зрительного нерва происходит при нормальных показателях внутриглазного давления.В обзоре обобщены современные представления о ключевой роли биомеханических факторов в патогенезе и диагностике ГНД. Основное внимание уделено структурно-функциональным особенностям корнеосклеральной оболочки глаза, включая роговицу и склеру, а также решетчатой пластинки (РП), которые определяют устойчивость тканей к механическому стрессу. Особое значение имеют современные методы оценки биомеханических свойств, такие как корнеальный гистерезис, динамическая тонометрия (ORA, Corvis ST) и визуализация РП с помощью оптической когерентной томографии, которые позволяют выявлять ранние изменения, не обнаруживаемые стандартными методами.Обзор подчеркивает необходимость дальнейших исследований для стандартизации биомеханических параметров и разработки новых диагностических подходов, включая нагрузочные пробы. Интеграция биомеханических данных в клиническую практику может улучшить раннюю диагностику ГНД.</p></abstract><trans-abstract xml:lang="en"><p>Normal-tension glaucoma (NTG) is a complex form of primary open-angle glaucoma characterized by progressive optic nerve damage despite normal intraocular pressure (IOP) levels.This review summarizes current concepts regarding the key role of biomechanical factors in the pathogenesis and diagnosis of NTG. Particular emphasis is placed on the structural and functional properties of the corneoscleral shell, including the cornea and sclera, as well as the lamina cribrosa (LC), which determine tissue resistance to mechanical stress. Modern methods for assessing biomechanical properties — such as corneal hysteresis, dynamic tonometry (ORA, Corvis ST), and lamina cribrosa imaging using optical coherence tomography — are of special importance, as they allow the detection of early changes that may not be identified with conventional diagnostic tools.The review emphasizes the need for further research to standardize biomechanical parameters and develop novel diagnostic approaches, including stress tests. Integrating biomechanical data into clinical practice may improve the early detection of NTG.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>первичная открытоугольная глаукома</kwd><kwd>глаукома нормального давления</kwd><kwd>биомеханика корнеосклеральной оболочки глаза</kwd><kwd>корнеальный гистерезис</kwd><kwd>внутриглазное давление</kwd><kwd>оптическая когерентная томография</kwd><kwd>нагрузочные пробы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>primary open-angle glaucoma</kwd><kwd>normaltension glaucoma</kwd><kwd>corneoscleral biomechanics</kwd><kwd>corneal hysteresis</kwd><kwd>intraocular pressure</kwd><kwd>optical coherence tomography</kwd><kwd>stress tests</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Национальное руководство по глаукоме: для практикующих врачей. 4-е изд., испр. и доп. Под ред. Егорова Е.А., Еричева В.П. 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