glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.53432/2078-4104-2025-24-4-37-44glaucoma-594Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESК вопросу о классификации пигментной глаукомыOn the classification of pigmentary glaucomahttps://orcid.org/0000-0003-0547-7521ЮрьеваТ. Н.IurevaT. N.

Юрьева Татьяна Николаевна, д.м.н., профессор, врач-офтальмолог, заместитель директора по научной работе Иркутского филиала, профессор кафедры офтальмологии, профессор кафедры глазных болезней

664033, Иркутск, ул. Лермонтова, 337

664079, Иркутск, м/р Юбилейный, 100

664003, Иркутск, ул. Красного Восстания, 1

Dr. Sci. (Med.), Professor, ophthalmologist, Deputy Director for Scientific Work,  Professor at the Academic Department of Ophthalmology, Professor at the Academic Department  of Eye Diseases

337 Lermontov St., Irkutsk, Russian Federation, 664033

100 Yubileyny mikrorayon, Irkutsk, Russian Federation, 664049

1 Krasnogo Vosstania St., Irkutsk,, 664003

tnyurieva@mail.ruhttps://orcid.org/0000-0002-4264-4408ЩукоА. Г.ShchukoA. G.

д.м.н., профессор, директор, заведующий кафедрой офтальмологии,  заведующий кафедрой глазных болезней

664033, Иркутск, ул. Лермонтова, 337

664079, Иркутск, м/р Юбилейный, 100

664003, Иркутск, ул. Красного Восстания, 1

Dr. Sci. (Med.), Professor, Director, Head of the Academic Department of Ophthalmology, Head of the Academic Department of Eye Diseases

337 Lermontov St., Irkutsk, Russian Federation, 664033

100 Yubileyny mikrorayon, Irkutsk, Russian Federation, 664049

1 Krasnogo Vosstania St., Irkutsk,, 664003

ИФ ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова Минздрава России; Иркутская государственная медицинская академия последипломного образования — филиал ФГБОУ ДПО РМАНПО Минздрава России; ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава РоссииРоссияIrkutsk Branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery"; Irkutsk State Medical Academy of Postgraduate Education – Branch of Russian Medical Academy of Continuing Professional Education; Irkutsk State Medical UniversityRussian Federation2025011220252443744Copyright © Юрьева Т.Н., Щуко А.Г., 20252025Юрьева Т.Н., Щуко А.Г.Iureva T.N., Shchuko A.G.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/594

В данной статье авторы попытаются ответить на вопрос, к какой классификационной форме (первичная или вторичная открытоугольная) должна быть отнесена пигментная глаукома, являющаяся клиническим этапом, завершающим прогредиентное течение синдрома пигментной дисперсии (СПД). Представлены факторы риска, патогенетические механизмы, клинические проявления СПД на последовательных стадиях его развития, коротко затронут вопрос о профилактике пигментной глаукомы.Литературные данные и результаты собственных исследований, как нам кажется, убедительно свидетельствуют о вторичном характере пигментной глаукомы и о необходимости пересмотра существующей классификации.

In this article, the authors attempt to answer the question of which classification form (primary or secondary open-angle) should be assigned to pigmentary glaucoma, which is a clinical stage that completes the progressive course of pigment dispersion syndrome (PDS). The article presents risk factors, pathogenetic mechanisms, and clinical manifestations of PDS at successive stages of its development and briefly discusses the issue of pigmentary glaucoma prevention. Based on literature data and the authors’ own research, the evidence strongly supports the secondary nature of pigmentary glaucoma and the need to revise current classification schemes.

пигментная глаукомасиндром пигментной дисперсииклассификация глаукомыстадии пигментной глаукомыpigmentary glaucomapigment dispersion syndromeglaucoma classificationstages of pigmentary glaucomaReferencesНестеров А.П., Бунин А.Я. О новой классификации первичной глаукомы. Вестник офтальмологии 1977; 5:38-42.Nesterov A.P., Bunin A.Ya. On the new classification of primary glaucoma. Russian Annals of Ophthalmology 1977; 5:38-42.Нестеров А.П., Егоров Е.А. Классификация глаукомы. Клиническая офтальмология 2001; 2(2):35-37.Nesterov A.P., Egorov E.A. Classification of Glaucoma. Clinical Ophthalmology 2001; 2(2):35-37.European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. British Journal of Ophthalmology 2021; 105; 1-169. https://doi.org/10.1136/BJOPHTHALMOL-2021-EGSGUIDELINESEuropean Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. British Journal of Ophthalmology 2021; 105; 1-169. https://doi.org/10.1136/BJOPHTHALMOL-2021-EGSGUIDELINESKiuchi, Y., Inoue, T., Shoji, N. et al. The Japan Glaucoma Society guidelines for glaucoma 5th edition. Jpn J Ophthalmol 2023; 67; 189-254. https://doi.org/10.1007/s10384-022-00970-9Kiuchi, Y., Inoue, T., Shoji, N. et al. The Japan Glaucoma Society guidelines for glaucoma 5th edition. Jpn J Ophthalmol 2023; 67; 189-254. https://doi.org/10.1007/s10384-022-00970-9Krukenberg F. Beiderseitigeangeborene melanse der hornhaut. Klin Monatsbl Augenbeilkd 1899; 37:254-258.Krukenberg F. Beiderseitigeangeborene melanse der hornhaut. Klin Monatsbl Augenbeilkd 1899; 37:254-258.Levinsohon G. Beitrag zurnpathologisch e anatomie und pathologie des glaukoms. Arch Augenbeilkd 1909; 62:131.Levinsohon G. Beitrag zurnpathologisch e anatomie und pathologie des glaukoms. Arch Augenbeilkd 1909; 62:131.Sugar H.S., Barbour F.A. Pigmentary glaucoma: a rare clinical entitу. Am J Ophthalmol 1949; 32:90-92.Sugar H.S., Barbour F.A. Pigmentary glaucoma: a rare clinical entitу. Am J Ophthalmol 1949; 32:90-92.Sugar H.S. Pigmentary glaucoma: a 25-year review. Am J Ophthalmol 1966; 62:499-507.Sugar H.S. Pigmentary glaucoma: a 25-year review. Am J Ophthalmol 1966; 62:499-507.Liebmann J.M., Tello C., Chew S.J., Cohen H., Ritch R. Prevention of blinking alters iris configuration in pigment dispersion syndrome and in normal eyes. Ophthalmology 1995; 102:446-455. https://doi.org/10.1016/s0161-6420(95)31001-9.Liebmann J.M., Tello C., Chew S.J., Cohen H., Ritch R. Prevention of blinking alters iris configuration in pigment dispersion syndrome and in normal eyes. Ophthalmology 1995; 102:446-455. https://doi.org/10.1016/s0161-6420(95)31001-9.Campbell D.G., David G. Pigmentary Dispersion and Glaucoma. Archives of Ophthalmol 1979; 97(9):1667.Campbell D.G., David G. Pigmentary Dispersion and Glaucoma. Archives of Ophthalmol 1979; 97(9):1667.Karickhoff J.R. Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment, and a new technique. Ophthalmic Surg 1992; 23:269-277.Karickhoff J.R. Pigmentary dispersion syndrome and pigmentary glaucoma: a new mechanism concept, a new treatment, and a new technique. Ophthalmic Surg 1992; 23:269-277.Campbell D.G., Schertzer R.M. Pathophysiology of pigment dispersion syndrome and pigmentary glaucoma. Curr Opin Ophthalmol 1995; 6(2):96-101. https://doi.org/10.1097/00055735-199504000-00015.Campbell D.G., Schertzer R.M. Pathophysiology of pigment dispersion syndrome and pigmentary glaucoma. Curr Opin Ophthalmol 1995; 6(2):96-101. https://doi.org/10.1097/00055735-199504000-00015.Kupfer C., Kuwabara T., Kaiser-Kupfer M. The histopathology of pigmentary dispersion syndrome with glaucoma. Am J Ophthalmol 1975; 80:857-886. https://doi.org/10.1016/0002-9394(75)90283-4.Kupfer C., Kuwabara T., Kaiser-Kupfer M. The histopathology of pigmentary dispersion syndrome with glaucoma. Am J Ophthalmol 1975; 80:857-886. https://doi.org/10.1016/0002-9394(75)90283-4.Gottanka J., Johnson D.H., Grehn F. Histologic Findings in Pigment Dispersion Syndrome and Pigmentary Glaucoma. Journal of Glaucoma 2006; 15(2):142-151. https://doi.org/10.1097/00061198-200604000-00011.Gottanka J., Johnson D.H., Grehn F. Histologic Findings in Pigment Dispersion Syndrome and Pigmentary Glaucoma. Journal of Glaucoma 2006; 15(2):142-151. https://doi.org/10.1097/00061198-200604000-00011.Richardson T.M., Hutchinson B.T. Grant WM. The outflow tract in pigmentary glaucoma: a light and electron microscopic study. Arch Ophthalmol 1977; 95:1015-1025. https://doi.org/10.1001/archopht.1977.04450060101010.Richardson T.M., Hutchinson B.T. Grant WM. The outflow tract in pigmentary glaucoma: a light and electron microscopic study. Arch Ophthalmol 1977; 95:1015-1025. https://doi.org/10.1001/archopht.1977.04450060101010.Alvarado J.A., Murphy C.G. Outflow obstruction in pigmentary and primary open angle glaucoma. Arch Ophthalmol 1992; 110:1769-1778. https://doi.org/10.1001/archopht.1992.01080240109042.Alvarado J.A., Murphy C.G. Outflow obstruction in pigmentary and primary open angle glaucoma. Arch Ophthalmol 1992; 110:1769-1778. https://doi.org/10.1001/archopht.1992.01080240109042.Kuchle M., Vinores S.A., Mahlow J., et al. Blood-aqueous barrier in pseudoexfoliation syndrome: evaluation by immunohistochemical staining of endogenous albumin. Br J Ophthalmol 1998; 82:1429-1432. https://doi.org/10.1007/BF00186513.Kuchle M., Vinores S.A., Mahlow J., et al. Blood-aqueous barrier in pseudoexfoliation syndrome: evaluation by immunohistochemical staining of endogenous albumin. Br J Ophthalmol 1998; 82:1429-1432. https://doi.org/10.1007/BF00186513.Epstein D.L. Pigment dispersion and pigmentary glaucoma. In: Chandler PA, Grant WM (eds) glaucoma. Lea & Febiger, Philadelphia, 1979. Рp. 122–131.Epstein D.L. Pigment dispersion and pigmentary glaucoma. In: Chandler PA, Grant WM (eds) glaucoma. Lea & Febiger, Philadelphia, 1979. Рp. 122–131.Richter C.U., Richardson T.M., Grant W.M. Pigmentary dispersion syndrome and pigmentary glaucoma: a prospective study of the natural history. Arch Ophthalmol 1986; 104:211-215. https://doi.org/10.1001/archopht.1986.01050140065021.Richter C.U., Richardson T.M., Grant W.M. Pigmentary dispersion syndrome and pigmentary glaucoma: a prospective study of the natural history. Arch Ophthalmol 1986; 104:211-215. https://doi.org/10.1001/archopht.1986.01050140065021.Scuderi G., Contestabile M.T., Scuderi L., Librando A., Fenicia V., Rahimi S. Pigment dispersion syndrome and pigmentary glaucoma: a review and update. Int Ophthalmol 2019; 39(7):1651-1662. https://doi.org/10.1007/s10792-018-0938-7.Scuderi G., Contestabile M.T., Scuderi L., Librando A., Fenicia V., Rahimi S. Pigment dispersion syndrome and pigmentary glaucoma: a review and update. Int Ophthalmol 2019; 39(7):1651-1662. https://doi.org/10.1007/s10792-018-0938-7.Niyadurupula N., Broadway D.C. Pigment dispersion syndrome and pigmentary glaucoma — a major review. Clin Exp Ophthalmol 2008; 38:868-882. https://doi.org/10.1111/j.1442-9071.2009.01920.x.Niyadurupula N., Broadway D.C. Pigment dispersion syndrome and pigmentary glaucoma — a major review. Clin Exp Ophthalmol 2008; 38:868-882. https://doi.org/10.1111/j.1442-9071.2009.01920.x.Farrar S.M., Shields M.B., Miller K.N., Stoup C.M. Risk factors for the development and severity of glaucoma in the pigment dispersion syndrome. Am J Ophthalmol 1989; 108:223-229. https://doi.org/10.1016/0002-9394(89)90110-4.Berger A., Ritch R., McDermott J., Wang R.F. Pigmentary dispersion,Berger A., Ritch R., McDermott J., Wang R.F. Pigmentary dispersion, refraction and glaucoma. Invest Ophthalmol Vis Sci 1987; 28:134.refraction and glaucoma. Invest Ophthalmol Vis Sci 1987; 28:134.Klingenstein A., Kernt M., Seidensticker F., et al. Anterior-segment morphology and corneal biomechanical characteristics in pigmentary glaucoma. Clin Ophthalmol 2014; 8:119126. https://doi.org/10.2147/OPTH.S53088.Klingenstein A., Kernt M., Seidensticker F., et al. Anterior-segment morphology and corneal biomechanical characteristics in pigmentary glaucoma. Clin Ophthalmol 2014; 8:119126. https://doi.org/10.2147/OPTH.S53088.Pavlin C.J., Macken P., Trope G.E., Harasiewics K., Foster F.S. Accomodation and iridotomy in the pigment dispersion syndrome. Ophthalmic Surg Lasers 1996; 27:113-120.Pavlin C.J., Macken P., Trope G.E., Harasiewics K., Foster F.S. Accomodation and iridotomy in the pigment dispersion syndrome. Ophthalmic Surg Lasers 1996; 27:113-120.Юрьева Т.Н. Закономерности формирования и разработка патогенетически обоснованного принципа лечения синдрома пигментной дисперсии: Дисс. канд. мед. наук. Иркутск, 1999. 140.Yurieva T.N. Patterns of formation and development of a pathogenetically substantiated principle of treatment for pigment dispersion syndrome. Cand. Med. Sci. dissertation. Irkutsk, 1999. 140 p.Щуко А.Г., Юрьева Т.Н., Чекмарева Л.Т., Малышев В.В.. Патент RU 2215500 C2. Способ определения стадий развития синдрома пигментной дисперсии глаза. 10.11.2003. Заявка № 2001127963/14 от 16.10.2001.Shchuko A.G., Yurieva T.N., Chekmareva L.T., and Malyshev V.V. Patent RU 2215500 C2. Method for Determining the Stages of Development of Pigment Dispersion Syndrome of the Eye. 10.11.2003. Application No. 2001127963/14, filed on 16.10.2001.Щуко А.Г., Юрьева Т.Н. Синдром пигментной дисперсии. Часть 1. Закономерности формирования, обоснование клинической классификации. Глаукома. Журнал НИИ ГБ РАМН 2012; 4:39-45.Shchuko A.G., Yurieva T.N. Pigment dispersion syndrome. Part 1. Patterns of formation, substantiation of clinical classification. Glaucoma. Journal of the Research Institute of Glaucoma of the Russian Academy of Medical Sciences 2012; 4:39-45.Scott A., Kotecha A., Bunce C., et al. YAG laser peripheral iridotomy for the prevention of pigment dispersion glaucoma. A prospective, randomized, controlled trial. Ophthalmology 2011; 118:468-473. https://doi.org/10.1016/j.ophtha.2010.07.026.Scott A., Kotecha A., Bunce C., et al. YAG laser peripheral iridotomy for the prevention of pigment dispersion glaucoma. A prospective, randomized, controlled trial. Ophthalmology 2011; 118:468-473. https://doi.org/10.1016/j.ophtha.2010.07.026.Щуко А.Г., Юрьева Т.Н. Синдром пигментной дисперсии (СПД). Часть 2. Патогенетическое обоснование и оценка эффективности лазерной иридэктомии при СПД. Глаукома. Журнал НИИ ГБ РАМН 2013; 2:47-52.Shchuko A.G., Yurieva T.N. Pigment dispersion syndrome (PDS). Part 2. Pathogenetic substantiation and evaluation of the effectiveness of laser iridectomy in PDS. Glaucoma. Journal of the Research Institute of Glaucoma of the Russian Academy of Medical Sciences 2013; 2:47-52.Щуко А.Г. и др. Редкие формы глаукомы. Иркутск: PR-студия 2002; 104-133.Shchuko A.G. et al. Rare Forms of Glaucoma. Irkutsk, PR-Studio, 2002. Pp. 104-133.Gandolfi S.A., Ungaro N., Tadini M.G, et al. A 10 year follow-up to determine the effect of YAG laser iridotomy on the natural history of pigment dispersion syndrome: a randomized clinical trial. JAMA Ophthalmol 2014; 132:1433-1438. https://doi.org/10.1001/jamaophthalmol.2014.3291.Gandolfi S.A., Ungaro N., Tadini M.G, et al. A 10 year follow-up to determine the effect of YAG laser iridotomy on the natural history of pigment dispersion syndrome: a randomized clinical trial. JAMA Ophthalmol 2014; 132:1433-1438. https://doi.org/10.1001/jamaophthalmol.2014.3291.Michelassi M., Lindsley K. Peripheral iridotomy for pigmentary glaucoma. Cochrane Database Syst Rev 2016; 2(2):CD005655. https://doi.org/10.1002/14651858.CD005655.pub2Michelassi M., Lindsley K. Peripheral iridotomy for pigmentary glaucoma. Cochrane Database Syst Rev 2016; 2(2):CD005655. https://doi.org/10.1002/14651858.CD005655.pub2.

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