ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-3-381-388ophthalmology-1589Research ArticleОБЗОРЫREVIEWSРоль оптической когерентной томографии в диагностике заболеваний закрытого угла передней камеры. Часть 2: Визуализация заднего сегмента глазаThe Role of Optical Coherence Tomography in the Diagnosis of Angle Closed Diseases of the Anterior Chamber. Part 2: Visualization of the Posterior Segment of the Eyehttps://orcid.org/0000-0002-2265-6671КурышеваН. И.KuryshevaN. I.

Курышева Наталия Ивановна - доктор медицинских наук, профессор, заведующая кафедрой глазных болезней; заведующая кафедрой офтальмологии; руководитель консультативно-диагностического отдела 

ул. Гамалеи, 15, Москва, 123098

Kurysheva Natalia I - МD, Professor, Head of the Ophthalmology department, head of the Consultative and diagnostic department

Gamalei str., 15, Moscow, 123098

https://orcid.org/0000-0002-7163-4858ШароваГ. А.SharovaG. А.

Шарова Галина Аркадьевна - заведующая диагностическим офтальмологическим отделением, лазерный хирург 

просп. Буденного, 26/2, Москва, 105118

Sharova Galina A. - head of the Diagnostic ophthalmology department, laser surgeon 

Budenny ave., 26/2, Moscow, 105118

galina.shar@mail.ruМедико-биологический университет инноваций и непрерывного образования ФГБУ ГНЦ РФ — «Федеральный биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентства; Консультативно-диагностический отдел Центра офтальмологии Федерального медико-биологического агентства, ФГБУ ГНЦ РФ — «Федеральный биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентства; Академия постдипломного образования ФБГУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий» Федерального медико-биологического агентстваРоссияThe Department of Eye Diseases at the Medical Biological University of Innovations and Continuing Education of the Federal Biophysical Center named after A.I. Burnazyan of FMBA of Russia; Diagnostic Department of the Ophthalmological Center of Federal Medical‐Biological Agency; Academy of postgraduate education under FSBU FSCC of FMBA of RussiaRussian FederationООО «Глазная клиника доктора Беликовой»РоссияOphthalmology Clinic of Dr. BelikovaRussian Federation202128092021183381388Copyright © Курышева Н.И., Шарова Г.А., 20212021Курышева Н.И., Шарова Г.А.Kurysheva N.I., Sharova G.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1589

Целью настоящей работы является обзор литературных данных, посвященный роли оптической когерентной томографии в диагностике заболеваний закрытого угла передней камеры. Представлен анализ применения современных технических устройств — оптической когерентной томографии заднего отрезка глаза, моделей с частотно-модулируемым источником (Swept Source). Появление новых технологий визуализации, таких как SS-OCT, способствует пониманию патогенеза заболеваний первичного закрытия угла передней камеры с точки зрения вовлечения в процесс сосудистой оболочки глаза. Более толстая сосудистая оболочка в макулярной зоне может быть анатомическим фактором риска развития заболеваний закрытого угла. Расширение аномально толстой хориоидеи в сочетании с особенностями строения переднего сегмента на глазах с короткой аксиальной длиной, в том числе на фоне психоэмоционального стресса, может привести к приступу закрытия угла. Визуализация структур заднего сегмента глаза представляет собой важную часть стратегии с целью выявления факторов риска, диагностики, мониторинга и оценки эффективности лечения болезней первичного закрытия угла. Качественный и количественный анализ данных на основе оптической когерентной томографии существенно повышает точность диагностики, позволяет прогнозировать течение заболевания и определять его прогрессирование. Это играет ключевую роль в выборе тактики лечения закрытого угла передней камеры. В обзоре рассмотрено влияние местных гипотензивных препаратов на сосудистую оболочку глаза.

Заключение. Оптическая когерентная томография является эталоном в современной диагностике и оценке эффективности лечения заболеваний первичного закрытия угла, позволяя лучше понять патогенез заболевания и его комплексный характер. Визуализация повышает возможности точной диагностики и правильного выбора тактики лечения.

The purpose of this work is to review the literature data on the role of optical coherence tomography in the diagnosis of diseases of the closed angle of the anterior chamber. The analysis of the use of modern technical devices — optical coherence tomography of the posterior segment, models with a frequency-modulated source (Swept Source) is presented. The emergence of new imaging technologies such as SS-OCT contributes to understanding the pathogenesis of primary angle closure diseases in terms of involvement of the choroid in the process. A thicker choroid in the macular area may be an anatomical risk factor for closed angle disease. The expansion of an abnormally thick choroid in combination with the structural features of the anterior segment in eyes with a short axial length, including against the background of psychoemotional stress, can lead to an attack of angle closure. Visualization of the structures of the posterior segment of the eye is an important part of the strategy aimed at solving the problem of identifying risk factors, diagnosing, monitoring and evaluating the effectiveness of treatment of diseases of primary angle closure. Qualitative and quantitative data analysis based on optical coherence tomography significantly increases the diagnostic accuracy, allows to determine its progression and to predict its course. This plays a key role in the choice of treatment tactics for the anterior chamber angle closure. The review considers the effect of local antihypertensive eye drops on the choroid.

Conclusion. Optical coherence tomography is a standard in modern diagnostics and evaluation of the effectiveness of treatment of diseases of primary angle closure, allowing a better understanding of the pathogenesis of the disease and its complex nature. Imaging improves the ability to accurately diagnose and choose the right treatment strategy.

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