The literature analysis confirms the interrelationship of thyroid gland pathology and glaucoma. Patients with diffusetoxic goiter (DTG) and endemic goiter have an especially high risk of developing glaucoma, while those with autoimmune thyroiditis face a moderate risk. The prevalence of primary open angle glaucoma (POAG) in patients over 40 with endocrine ophthalmopathy is reliably associated with the male gender and the duration of the disease longer than 60 months. An increased risk of POAG is noted in men with hypothyroidism averagely aged 69. In most cases, ophthalmic hypertension that accompanies endocrine pathology does not need any topical hypotensive treatment. The main pathogenetically validated therapy of thyroid disorders results in a reduction of IOP level and an improvement of fluid outflow from the eye.
Recently, much literature data is available on the issue of diagnosis of preperimetric glaucoma (PPG), but no recognized algorithms of detecting primary open-angle glaucoma (POAG) at this stage have been developed, and there is no general opinion as to what parameters and techniques should be used. The review offers a generalization of the literature data on PPG diagnosing and specifies the main parameters that should be taken into account in testing POAG patients at the early preperimetric stage. As is known, the diagnosis of glaucoma is based on detectable changes in the optic nerve head and visual field, but the onset of the disease occurs long before the above changes. Currently, the approach shifts towards early OCT diagnosis of glaucoma. Cohort studies show that structural disorders are detected 5–12 years earlier than functional ones in 17–60 % patients with POAG.
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