glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2025-24-4-24-35glaucoma-593Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESМесто псевдоэксфолиативной глаукомы в современной иерархии глаукомPseudoexfoliative glaucoma in the current glaucoma hierarchyБрежневА. Ю.BrezhnevA. Yu.

Брежнев Андрей Юрьевич - к.м.н., доцент кафедры офтальмологии

305041, Курск, ул. К. Маркса, 3

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

3 Karla Marksa St., Kursk, 305041

drbrezhnev@hotmail.comФГБОУ ВО «Курский государственный медицинский университет»РоссияKursk State Medical UniversityRussian Federation2025011220252442435Copyright © Брежнев А.Ю., 20252025Брежнев А.Ю.Brezhnev A.Y.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/593

Псевдэксфолиативный синдром (ПЭС) — системноезаболевание, характеризующееся накоплением аномального внеклеточного материала в различных структурахглаза и экстраокулярных тканях. Многочисленные исследования подтверждают его связь с развитием псевдэксфолиативной глаукомы (ПЭГ), которая наряду с типичнымихарактеристиками глауком имеет целый ряд генетических,морфологических, иммунологических, биохимических,клинических особенностей, отличающих ее от «классической» первичной открытоугольной глаукомы. Это позволяет рассматривать ПЭГ не просто как разновидностьпервичной или вторичной открытоугольной глаукомы,а как особую форму заболевания, требующую, помимостандартных технологий, разработки качественно новых,специфичных подходов к ранней диагностике, мониторингу, медикаментозной и хирургической коррекции.В данной статье рассматривается место ПЭГ в современных классификациях схемах, их дискуссионныйхарактер, возможные корреляции ПЭС с закрытоугольной глаукомой и глаукомой нормального давления,попытки поиска патогенетически обоснованных методов лечения. Появление в арсенале офтальмологовподобных возможностей позволит вернуться к вопросупересмотра существующих классификационных схемс возможным выделением ПЭГ в отдельную категорию

Pseudoexfoliation syndrome (PEX) is a systemic disease characterized by the accumulation of abnormal extracellular material in various ocular structures and extraocular tissues. Numerous studies have confirmed its association with the development of pseudoexfoliative glaucoma (PEXG), which, along with typical glaucomatous features, exhibits a range of genetic, morphological, immunological, biochemical, and clinical characteristics that distinguish it from "classic" primary open-angle glaucoma. This allows PEXG to be considered not merely as a subtype of primary or secondary open-angle glaucoma but rather as a distinct form of the disease requiring — in addition to standard approaches — the development of qualitatively new, specific strategies for early diagnosis, monitoring, and medical or surgical treatment.

This article discusses the place of PEXG in current classifications, their debatable nature, possible correlations of PEX with angle-closure glaucoma and normal-tension glaucoma, and attempts to identify pathogenetically justified treatment methods. The emergence of such therapeutic options in ophthalmology may prompt a reconsideration of existing classification frameworks and the potential recognition of PEXG as a separate category.

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