The role of endothelium dysfunction in the pathogenesis of vascular ocular diseases

ФГАУ «ФГАУ НМИЦ нейрохирургии им. академика Н.Н. Бурденко» Минздрава России, Москва Для цитирования: Серова Н.К. Дифференциальная диагностика оптической нейропатии у пациентов при патологических процессах центральной нервной системы и глаукоме нормального давления // Офтальмологические ведомости." В статье представлены особенности офтальмологических проявлений определённой патологии центральной нервной системы с симптоматикой клинически схожей с симптоматикой глаукомы нормального давления, позволяющие проводить дифференциальную диагностику этих патологических процессов." Ключевые слова: оптическая нейропатия; глаукома нормального давления; патология центральной нервной системы.

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Differential diagnosis of optic neuropathy in patients with CNS diseases and normal tension glaucoma

Serova

Константиновна²

2019

Ophthalmology Reports

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Central Serous Chorioretinopathy from the Point of View of OCT-Angiography. Part 1. Chorioretinal Blood Flow Changes

et al. 2018

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Numerous recent studies indicate that the key mechanism for the development of central serous chorioretinopathy (CSR) is damage to retinal pigment epithelium (RPE). At the same time, the reports appeared in recent years indicate that an equally important link in pathogenesis is the disturbances of the choroidal blood flow. Thus, the introduction into clinical practice of optical coherence tomography in the angiography (OCTA) mode made it possible to visualize the retinal and choroidal vessels taking into account their segmentation, which opens up prospects for studying chorioretinal blood flow in the CSR.Purpose:to reveal the regularities of the change in the choroidal blood flow in patients with SCR according to the OCTA data, to assess their informativeness and role in the pathogenesis of the disease.Patients and methods:26 patients with SCR aged 35–54 years were examined. To assess the chorioretinal blood flow, optical coherence tomography of the retina is included in the angiography mode in the scope of the diagnostic examination.Results and discussion:It has been revealed that the number of large vessels in the immediate vicinity of the RPE is increasing in SCR, i.e. the vessels move towards the retina in the direction of the least resistance. Disturbance of the hierarchy of the vasculature is an important fact, allowing to speak about pronounced hemodynamic disorders. Disturbance of the topography of large-caliber vessels is accompanied by the formation of a characteristic vascular pattern. The revealed predominance of the reticular pattern of large vessels in patients with CSR is more likely due to the presence of a significant number of bifurcations and anastomoses, as well as an increase in the proportion of crossed vessels. This may be accompanied by an increase in total vascular resistance. Consequently, the hydraulic resistance can increase at these sites, a turbulent blood flow occurs and the permeability of the vascular wall increases. Correspondence between changes in RPE and choriocapillaries was established. Taking into account that the RPE detachments from 450 to 780 (on average 515 ± 72.3) μm, revealed in the projection of the altered choriocapillaries, have comparable sizes with the value of one vascular lobe (515 × 450) μm, one can speak of a local lesion of choriocapillaries and RPE within one arteriocentric lobules.Conclusions:The revealed changes in regional blood flow are progressive and can be used as classification and prognostic criteria for choroidal dysfunction.

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Association between polymorphic <i>eNOS</i> gene markers and risk of primary open-angle glaucoma in the Perm Region population

Гаврилова¹,

Kinkulkina

Avagyan

et al. 2022

Russian Journal of Immunology

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Glaucoma is widely known to have a progressive course and occupy a leading place among the causes of vision loss and blindness. Increased intraocular pressure is the key harmful factor among the causes of glaucoma occurrence. In some cases, however, the progressive disease is also observed at normal values of ophthalmic tonus. Early diagnosis of glaucoma will allow for timely therapy, which in turn will reduce the risk of complications and prevent neuroopticopathy progression. According to the literature data, the pathogenesis of primary open-angle glaucoma is associated with nitric oxide (NO), due to imbalance between endothelium-produced vasoconstrictors and vasodilators, especially, endotelin-1 and nitric oxide. Decreased NO level combined with endotelin-1 hyperproduction is associated with development and progression of a number of ocular disorders including glaucomatous atrophy of the optic nerve. Since nitric oxide is produced by endothelial NO-synthase (eNOS), one may assume that eNOS is involved in pathogenesis of neurodegenerative changes in primary open-angle glaucoma. However, despite numerous studies on the pathogenesis of glaucoma, the distinct factors of innate immune response remain poorly studied. The purpose of the present study was a search for association between polymorphic markers (C774T, T786C, Glu298Asp) of the eNOS gene and the risk of primary open-angle glaucoma among the Perm Region residents. Peripheral blood of patients with primary open-angle glaucoma (the main group) and cataract without glaucoma (a comparison group) was used as initial biomaterial. In comparison group, arterial hypertension was most often encountered as concomitant pathology. Genomic DNA was first isolated from the blood samples, followed by rt-PCR using reagent kits for determining C774T, T786C, Glu298Asp polymorphic markers in the eNOS gene. The prevalence of polymorphic variants of the innate immunity genes T786C, C774T and Glu298Asp of the eNOS gene was analyzed in patients with primary open-angle glaucoma. There were no significant differences in the distribution of genotypes and alleles of eNOS gene for the C774T and Glu298Asp polymorphic markers. An increased frequency of homozygous TT genotype was found, along with decreased occurrence of C allele at the polymorphic T786C locus of the eNOS gene, as well as a trend for decreased frequency of the TC and CC genotypes. Arterial hypertension potentiated the negative effect of increased intraocular pressure upon the glaucoma-associated optic neuropathy. Conclusions. The studied changes in genotypes and allelic frequencies of eNOS gene may be regarded as risk factors that increase probability of the primary open-angle glaucoma and predict severity of the disease.

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The role of endothelium dysfunction in the pathogenesis of vascular ocular diseases

Cited by 3 publications

References 83 publications

Differential diagnosis of optic neuropathy in patients with CNS diseases and normal tension glaucoma

Differential diagnosis of optic neuropathy in patients with CNS diseases and normal tension glaucoma

Central Serous Chorioretinopathy from the Point of View of OCT-Angiography. Part 1. Chorioretinal Blood Flow Changes

Association between polymorphic <i>eNOS</i> gene markers and risk of primary open-angle glaucoma in the Perm Region population

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