Биоретинометрические критерии диагностики глаукомы, ассоциированной с миопией

Abstract

Purpose: To assess changes in the peripapillary retina and vessels of the arterial peripapillary circle of Zinn -Haller during the formation of glaucomatous optic neuropathy in patients with glaucoma associated with myopia. Methods: We examined 26 patients (26 eyes) with a moderate stage of primary open-angle glaucoma on eyes with high myopia and 30 people (30 eyes) with uncomplicated myopia. Optical coherence tomography in angiography mode was included in the standard ophthalmologic examination. Results : A rim area reduction (1.03±0.36 and 1.6±0.42; р=0.05) in patients with glaucoma develops against the background of choroid thinning, mainly in the lower (131.36±41.98 and 226.5±98.13; р=0.01) and nasal (57.63±9.81 and 216±122.4; р=0.0006) segments and is accompanied by an increase of the peripapillary atrophy area (1.94±0.5 and 1.05±0.15; р=0.005), which indicates the inconsistency of trophic and metabolic processes. Changes in the vascular topography of the Zinn - Haller arterial circle (reduction of the density of small branches, exposure of large vessels with the formation of non-perfusion zones) in the area of peripapillary atrophy due to oscillations of the ophthalmic nerve should be considered as ischemia of the optic nerve head resulting from a disruption of the peripapillary blood flow with a choroidal blood supply. Conclusion: Visualization and evaluation of dystrophic changes in the peripapillary retina and vascular topography of the Zinn - Haller arterial peripapillary circle can serve as the differential diagnostic criteria for glaucoma associated with myopia and be used to monitor the course of the glaucoma process.