СОСУДИСТАЯ ТЕОРИЯ ПАТОГЕНЕЗА ГЛАУКОМНОЙ ОПТИКОНЕЙРОПАТИИ: ФИЗИОЛОГИЧЕСКОЕ И ПАТОФИЗИОЛОГИЧЕСКОЕ ОБОСНОВАНИЕ. ЧАСТЬ 2
Аннотация
В обзоре рассмотрены некоторые физиологические механизмы регуляции глазного кровотока и их нарушения в аспекте развития глаукомной оптиконейропатии. Приводится характеристика перфузионного глазного давления, его связи с внутриглазным и артериальным давлением с акцентом на роль их циркадианных колебаний. В литературе имеется много данных о том, что развитие глаукомы связано со снижением перфузионного давления. Освещены проблемы ауторегуляции кровотока глаза, а также роли нейрососудистого взаимодействия в регуляции глазного кровотока. Особое внимание уделено ретинальному и хориоидальному кровотоку в сравнительном аспекте и с акцентом на регуляцию этих двух источников кровоснабжения сетчатки и зрительного нерва. Рассмотрены такие фундаментальные причины нарушения глазного кровотока при глаукоме, как эндотелиальная дисфункция и первичная сосудистая дисрегуляция. Подчеркивается многообразие факторов, участвующих в поддержании постоянства глазного кровотока, что делает проблематичным выбор терапии рассмотренных расстройств. Рассмотрены основные механизмы, поддерживающие постоянство ауторегуляции глазного кровотока, а также причины нарушения нейроваскулярного взаимодействия. Таким образом, несмотря на присутствие всех классических механизмов регуляции глазного кровотока, физиология и патофизиология глазной гемоперфузии в значительной степени уникальна.
Об авторе
Н. И. Курышева
Центр офтальмологии ФМБА России, Клиническая больница № 86
Россия
Россия
Курышева Наталия Ивановна, доктор медицинских наук, профессор, руководитель консультативно-диагностического отдела
123098, Москва, ул. Гамалеи, 15
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Рецензия
Для цитирования:
Курышева Н.И. СОСУДИСТАЯ ТЕОРИЯ ПАТОГЕНЕЗА ГЛАУКОМНОЙ ОПТИКОНЕЙРОПАТИИ: ФИЗИОЛОГИЧЕСКОЕ И ПАТОФИЗИОЛОГИЧЕСКОЕ ОБОСНОВАНИЕ. ЧАСТЬ 2. Национальный журнал Глаукома. 2017;16(4):98-109.
For citation:
Kurysheva N.I. VASCULAR THEORY OF THE GLAUCOMATOUS OPTIC NEUROPATHY PATHOGENESIS: PHYSIOLOGICAL AND PATHOPHYSIOLOGICAL RATIONALE. PART 2. National Journal glaucoma. 2017;16(4):98-109. (In Russ.)
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