ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2023-4-585-592ophthalmology-2225Research ArticleОБЗОРЫREVIEWSГлаукома нормального давления: эпидемиология, патогенез, диагностика и лечение. Обзор литературы. Часть 2. Роль сосудистой дисрегуляции и хориокапиллярного кровотока в патогенезе. ЛечениеNormal-Tension Glaucoma: Epidemiology, Pathogenesis, Diagnosis and Treatment. Literature Review. Part 2. Role of Vascular Dysregulation in the Pathogenesis. Treatment of Normal Tension Glaucomahttps://orcid.org/0000-0002-2265-6671КурышеваН. И.KuryshevaN. I.

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

ул. Живописная, 46, корп. 8, Москва, 123098;

 ул. Гамалеи, 15, Москва, 123098

Kurysheva Natalia I. МD, Professor, head of the Ophthalmology department;

head of the Consultative and diagnostic department

Zhivopisnaya str., 46, bld. 8, Moscow, 123098;

Gamalei str., 15, Moscow, 123098

https://orcid.org/0000-0002-8400-2817КимВ. Е.KimV. E.

Ким Валерия Енгировна, врач-офтальмолог

ул. Живописная, 46, корп. 8, Москва, 123098;

ул. Гамалеи, 15, Москва, 123098

Kim Valeriya E. оphthalmologist

Zhivopisnaya str., 46, bld. 8, Moscow, 123098;

Gamalei str., 15, Moscow, 123098

https://orcid.org/0009-0004-9171-1955ПлиеваХ. М.PlievaH. M.

Плиева Хава Магамедовна, врач-офтальмолог

ул. Живописная, 46, корп. 8, Москва, 123098;

ул. Гамалеи, 15, Москва, 123098

Plieva Hava M. оphthalmologist

Zhivopisnaya str., 46, bld. 8, Moscow, 123098;

Gamalei str., 15, Moscow, 123098

https://orcid.org/0000-0001-7861-5863КимВ. Ю.KimV. Yu.

Ким Виталий Юрьевич врач-офтальмолог

ул. Живописная, 46, корп. 8, Москва, 123098;

Гамалеи, 15, Москва, 123098

Kim Vitalij Yu. Оphthalmologist

Zhivopisnaya str., 46, bld. 8, Moscow, 123098;

Gamalei str., 15, Moscow, 123098

Медико-биологический университет инноваций и непрерывного образования ФГБУ «ГНЦ РФ — Федеральный медицинский биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентства; Консультативно-диагностический отдел Центра офтальмологии ФГБУ «ГНЦ РФ — Федеральный медицинский биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентства; Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияMedical Biological University of Innovations and Continuing Education of the Federal State Budgetary University the State Research Center — Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency; Ophthalmological Center of the Federal Medical and Biological Agency of the Russian Federation — Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency; Postgraduate Education Academy of the Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological AgencyRussian FederationМедико-биологический университет инноваций и непрерывного образования ФГБУ «ГНЦ РФ — Федеральный медицинский биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентства; Консультативно-диагностический отдел Центра офтальмологии ФГБУ «ГНЦ РФ — Федеральный медицинский биофизический центр им. А.И. Бурназяна» Федерального медико-биологического агентстваРоссияMedical Biological University of Innovations and Continuing Education of the Federal State Budgetary University the State Research Center — Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency; Ophthalmological Center of the Federal Medical and Biological Agency of the Russian Federation — Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological AgencyRussian Federation202327122023204585592Copyright © Курышева Н.И., Ким В.Е., Плиева Х.М., Ким В.Ю., 20232023Курышева Н.И., Ким В.Е., Плиева Х.М., Ким В.Ю.Kurysheva N.I., Kim V.E., Plieva H.M., Kim V.Y.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/2225

В патогенезе глаукомы нормального давления (ГНД) значительную роль играет нарушение регуляции вегетативной нервной системы, первичная сосудистая дисрегуляция, снижение перфузионного давления в сосудах сетчатки, зрительного нерва и хориоидеи и эндотелиальная дисфункция. Учитывая важность показателей глазного кровотока при ГНД, особую диагностическую и прогностическую значимость имеет исследование хориокапилляров с помощью ОКТ-ангиографии. Одним из важных критериев лечения ГНД является снижение внутриглазного давления (ВГД), которое достигается как консервативными методами лечения, так и лазерными, а также хирургическими вмешательствами. При своевременной диагностике, контроле ВГД и отслеживании морфофункциональных изменений в глазах с ГНД появляется возможность приостановить развитие глаукомной оптической нейропатии и сохранить зрение пациента на длительный срок.

Insufficient blood supply, vascular dysregulation, perfusion pressure and endothelial dysfunction may account for the pathogenic mechanism. OCT angiography (OCTA) measurements have been reported to be useful for glaucoma diagnostics. OCTA microvasculature could serve as a potential biomarker for glaucoma diagnosis. One of the important criteria for the treatment of NTG is the reduction of IOP, which is achieved by both conservative methods of treatment and laser and surgical interventions. With timely diagnosis, control of IOP and monitoring of morphofunctional changes in the eyes with NTG, it becomes possible to suspend the development of glaucoma optic neuropathy and preserve the patient’s vision for a long time.

глаукома нормального давлениясосудистая дисрегуляцияглазной кровотокОКТАлечениеnormal-tension glaucomavascular dysregulationeye hemoperfusionOCTAtreatmentReferencesJaeger E. Über Glaukom und seine Heilung durch Iridektomie. Z Ges Aerzte Wein. 1858;14:465–491.Jaeger E. Über Glaukom und seine Heilung durch Iridektomie. Z Ges Aerzte Wein. 1858;14:465–491.Katai N, Yoshimura N. Apoptotic retinal neuronal death by ischemia-reperfusion is executed by two distinct caspase family proteases. Invest Ophthalmol Vis Sci. 1999 Oct;40(11):2697–2705.Katai N, Yoshimura N. Apoptotic retinal neuronal death by ischemia-reperfusion is executed by two distinct caspase family proteases. Invest Ophthalmol Vis Sci. 1999 Oct;40(11):2697–2705.Phelps CD, Corbett JJ. Migraine and low-tension glaucoma. A case-control study. Invest Ophthalmol Vis Sci. 1985 Aug;26(8):1105–1108.Phelps CD, Corbett JJ. Migraine and low-tension glaucoma. A case-control study. Invest Ophthalmol Vis Sci. 1985 Aug;26(8):1105–1108.Курышева Н.И., Иртегова Е.Ю., Ясаманов А.Н. Роль эндотелиальной дисфункции в прогрессировании глаукомной оптической нейропатии. Российский офтальмологический журнал. 2015;14(2):34–39.Kurysheva NI, Irtegova EYu, Yasamanova AN. The role of endothelial dysfunction in glaucomatous optic neuropathy progression. Russian ophthalmological journal 2015;14(2):34–39 (In Russ.).Flammer J, Mozaffarieh M. Autoregulation, a balancing act between supply and demand. Can J Ophthalmol. 2008 Jun;43(3):317–321. doi: 10.3129/i08-056.Flammer J, Mozaffarieh M. Autoregulation, a balancing act between supply and demand. Can J Ophthalmol. 2008 Jun;43(3):317–321. doi: 10.3129/i08-056.Anders D, Vollenweider S, Cann J, Hofstetter M, Flammer J, Orgül S, Kräuchi K. Heart-rate variability in women during 40-hour prolonged wakefulness. Chronobiol Int. 2010 Sep;27(8):1609–1628. doi: 10.3109/07420528.2010.504317.Anders D, Vollenweider S, Cann J, Hofstetter M, Flammer J, Orgül S, Kräuchi K. Heart-rate variability in women during 40-hour prolonged wakefulness. Chronobiol Int. 2010 Sep;27(8):1609–1628. doi: 10.3109/07420528.2010.504317.Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z; EMGT Group. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007 Nov;114(11):1965–1972. doi: 10.1016/j.ophtha.2007.03.016.Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z; EMGT Group. Predic- tors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007 Nov;114(11):1965–1972. doi: 10.1016/j.ophtha.2007.03.016.Hayreh SS, Podhajsky P, Zimmerman MB. Role of nocturnal arterial hypotension in optic nerve head ischemic disorders. Ophthalmologica. 1999;213(2):76–96. doi: 10.1159/000027399.Hayreh SS, Podhajsky P, Zimmerman MB. Role of nocturnal arterial hypotension in optic nerve head ischemic disorders. Ophthalmologica. 1999;213(2):76–96. doi: 10.1159/000027399.Leung DYL, Tham CC. Normal-tension glaucoma: Current concepts and approaches-A review. Clin Exp Ophthalmol. 2022 Mar;50(2):247–259. doi: 10.1111/ceo.14043.Leung DYL, Tham CC. Normal-tension glaucoma: Current concepts and approaches-A review. Clin Exp Ophthalmol. 2022 Mar;50(2):247–259. doi: 10.1111/ceo.14043.Pasquale LR. Vascular and autonomic dysregulation in primary open-angle glaucoma. Curr Opin Ophthalmol. 2016 Mar;27(2):94–101. doi: 10.1097/ICU.0000000000000245.Pasquale LR. Vascular and autonomic dysregulation in primary open-angle glaucoma. Curr Opin Ophthalmol. 2016 Mar;27(2):94–101. doi: 10.1097/ICU.0000000000000245.Курышева Н.И. Глазная гемоперфузия и глаукома. М.: Гринлайт, 2014; 128 с.Kurisheva N.I. Eye hemoperfusion and glaucoma. Moscow: Grenlight Publ., 2014. 128 p. (In Russ.).Takahashi N, Kiyota N, Kunikata H, Yamazaki M, Nishimura T, Shiga Y, Aoyagi H, Shidomi M, Tsuda T, Ohtsuka T, Tomida T, Nakazawa T. Vasoreactivity of the optic nerve head, nailfold, and facial skin in response to cold provocation in normaltension glaucoma patients. BMC Ophthalmol. 2023 Jul 12;23(1):316. doi: 10.1186/s12886-023-03059-0.Takahashi N, Kiyota N, Kunikata H, Yamazaki M, Nishimura T, Shiga Y, Aoyagi H, Shidomi M, Tsuda T, Ohtsuka T, Tomida T, Nakazawa T. Vasoreactivity of the optic nerve head, nailfold, and facial skin in response to cold provocation in normaltension glaucoma patients. BMC Ophthalmol. 2023 Jul 12;23(1):316. doi: 10.1186/s12886-023-03059-0.Feke GT, Pasquale LR. Retinal blood flow response to posture change in glaucoma patients compared with healthy subjects. Ophthalmology. 2008 Feb;115(2):246–252. doi: 10.1016/j.ophtha.2007.04.055.Feke GT, Pasquale LR. Retinal blood flow response to posture change in glaucoma patients compared with healthy subjects. Ophthalmology. 2008 Feb;115(2):246–252. doi: 10.1016/j.ophtha.2007.04.055.Kurysheva NI, Ryabova TY, Shlapak VN. Heart rate variability: the comparison between high tension and normal tension glaucoma. EPMA J. 2018 Feb 22;9(1):35–45. doi: 10.1007/s13167-017-0124-4.Kurysheva NI, Ryabova TY, Shlapak VN. Heart rate variability: the comparison between high tension and normal tension glaucoma. EPMA J. 2018 Feb 22;9(1):35–45. doi: 10.1007/s13167-017-0124-4.Konieczka K, Ritch R, Traverso CE, Kim DM, Kook MS, Gallino A, Golubnitschaja O, Erb C, Reitsamer HA, Kida T, Kurysheva N, Yao K. Flammer syndrome. EPMA J. 2014 Jul 8;5(1):11. doi: 10.1186/1878-5085-5-11.Konieczka K, Ritch R, Traverso CE, Kim DM, Kook MS, Gallino A, Golubnitschaja O, Erb C, Reitsamer HA, Kida T, Kurysheva N, Yao K. Flammer syndrome. EPMA J. 2014 Jul 8;5(1):11. doi: 10.1186/1878-5085-5-11.Chang KC, Liu PF, Chang CH, Lin YC, Chen YJ, Shu CW. The interplay of autophagy and oxidative stress in the pathogenesis and therapy of retinal degenerative diseases. Cell Biosci. 2022 Jan 3;12(1):1. doi: 10.1186/s13578-021-00736-9.Chang KC, Liu PF, Chang CH, Lin YC, Chen YJ, Shu CW. The interplay of autophagy and oxidative stress in the pathogenesis and therapy of retinal degenerative diseases. Cell Biosci. 2022 Jan 3;12(1):1. doi: 10.1186/s13578-021-00736-9.Almeida INF, Taniguchi E, Tito CVA, Dias DT, Ushida M, Dorairaj S, Ritch R, Teixeira SH, Paranhos A Jr, Gracitelli CPB, Kayser C, Prata TS. Vascular parameters and endothelin-1 measurements in glaucoma patients with low- and high-tension optic disc hemorrhages. Sci Rep. 2023 Mar 28;13(1):5023. doi: 10.1038/s41598-023-31682-w.Almeida INF, Taniguchi E, Tito CVA, Dias DT, Ushida M, Dorairaj S, Ritch R, Teixeira SH, Paranhos A Jr, Gracitelli CPB, Kayser C, Prata TS. Vascular parameters and endothelin-1 measurements in glaucoma patients with low- and high-tension optic disc hemorrhages. Sci Rep. 2023 Mar 28;13(1):5023. doi: 10.1038/s41598-023-31682-w.Курышева Н.И., Царегородцева М.А., Рябова Т.Я., Шлапак В.Н. Перфузионное давление и первичная сосудистая дисрегуляция у больных глаукомой нормального давления. РМЖ: Клиническая офтальмология 2011;12(1):9–12.Kyrusheva NI, Tsaregorodtseva MA, Ryabova TYa, Shlapak VN. Perfusion pressure and primary vascular dysregulation in patients with normal tension glaucoma. Russian Medical Journal. Clinical Ophthalmology. 2011; 12 (1): 9-12. (in Russ.)Бакшинский П.П. Механизмы интегральной регуляции глазного кровотока. Глаукома. 2007;1:47–58.Bakshinsky P.P. Mechanisms of ocular blood flow integral regulation. Glaucoma. 2007;1:47–58 (In Russ.).Van Eijgen J, Heintz A, van der Pluijm C, Delporte M, De Witte D, Molenberghs G, Barbosa-Breda J, Stalmans I. Normal tension glaucoma: A dynamic optical coherence tomography angiography study. Front Med (Lausanne). 2023 Jan 6;9:1037471. doi: 10.3389/fmed.2022.1037471.Van Eijgen J, Heintz A, van der Pluijm C, Delporte M, De Witte D, Molenberghs G, Barbosa-Breda J, Stalmans I. Normal tension glaucoma: A dynamic optical coherence tomography angiography study. Front Med (Lausanne). 2023 Jan 6;9:1037471. doi: 10.3389/fmed.2022.1037471.Wang YM, Shen R, Lin TPH, Chan PP, Wong MOM, Chan NCY, Tang F, Lam AKN, Leung DYL, Tham CCY, Cheung CY. Optical coherence tomography angiography metrics predict normal tension glaucoma progression. Acta Ophthalmol. 2022 Nov;100(7):e1455–e1462. doi: 10.1111/aos.15117.Wang YM, Shen R, Lin TPH, Chan PP, Wong MOM, Chan NCY, Tang F, Lam AKN, Leung DYL, Tham CCY, Cheung CY. Optical coherence tomography angiography metrics predict normal tension glaucoma progression. Acta Ophthalmol. 2022 Nov;100(7):e1455–e1462. doi: 10.1111/aos.15117.Dumskyj MJ, Mathias CJ, Doré CJ, Bleasdale-Barr K, Kohner EM. Postural variation in intraocular pressure in primary chronic autonomic failure. J Neurol. 2002 Jun;249(6):712–718. doi: 10.1007/s00415-002-0697-1.Dumskyj MJ, Mathias CJ, Doré CJ, Bleasdale-Barr K, Kohner EM. Postural variation in intraocular pressure in primary chronic autonomic failure. J Neurol. 2002 Jun;249(6):712–718. doi: 10.1007/s00415-002-0697-1.Котляр К.Е., Дроздова Г.А., Шамшинова А.М. Гемодинамика глаза и современные методы исследования. Часть I. Глазное кровообращение и его количественная оценка. Глаукома. 2003;3:62–73.Kotlyar KE, Drozdova GA, Shamshinova AM. Hemodynamics of the eye and modern research methods. Part I. Ocular blood circulation and its quantitative assessment. Glaucoma. 2003;3:62–73 (In Russ.).Rusia D, Harris A, Pernic A, Williamson KM, Moss AM, Shoshani YZ, Siesky B. Feasibility of creating a normative database of colour Doppler imaging parameters in glaucomatous eyes and controls. Br J Ophthalmol. 2011 Sep;95(9):1193–1198. doi: 10.1136/bjo.2010.188219.Rusia D, Harris A, Pernic A, Williamson KM, Moss AM, Shoshani YZ, Siesky B. Feasibility of creating a normative database of colour Doppler imaging parameters in glaucomatous eyes and controls. Br J Ophthalmol. 2011 Sep;95(9):1193–1198. doi: 10.1136/bjo.2010.188219.Chung JK, Hwang YH, Wi JM, Kim M, Jung JJ. Glaucoma Diagnostic Ability of the Optical Coherence Tomography Angiography Vessel Density Parameters. Curr Eye Res. 2017 Nov;42(11):1458–1467. doi: 10.1080/02713683.2017.1337157.Chung JK, Hwang YH, Wi JM, Kim M, Jung JJ. Glaucoma Diagnostic Ability of the Optical Coherence Tomography Angiography Vessel Density Parameters. Curr Eye Res. 2017 Nov;42(11):1458–1467. doi: 10.1080/02713683.2017.1337157.Penteado RC, Zangwill LM, Daga FB, Saunders LJ, Manalastas PIC, Shoji T, Akagi T, Christopher M, Yarmohammadi A, Moghimi S, Weinreb RN. Optical Coherence Tomography Angiography Macular Vascular Density Measurements and the Central 10-2 Visual Field in Glaucoma. J Glaucoma. 2018 Jun;27(6):481–489. doi: 10.1097/IJG.0000000000000964.Penteado RC, Zangwill LM, Daga FB, Saunders LJ, Manalastas PIC, Shoji T, Akagi T, Christopher M, Yarmohammadi A, Moghimi S, Weinreb RN. Optical Coherence Tomography Angiography Macular Vascular Density Measurements and the Central 10-2 Visual Field in Glaucoma. J Glaucoma. 2018 Jun;27(6):481–489. doi: 10.1097/IJG.0000000000000964.Kwon J, Choi J, Shin JW, Lee J, Kook MS. Glaucoma Diagnostic Capabilities of Foveal Avascular Zone Parameters Using Optical Coherence Tomography Angiography According to Visual Field Defect Location. J Glaucoma. 2017 Dec;26(12):1120–1129. doi: 10.1097/IJG.0000000000000800.Kwon J, Choi J, Shin JW, Lee J, Kook MS. Glaucoma Diagnostic Capabilities of Foveal Avascular Zone Parameters Using Optical Coherence Tomography Angiography According to Visual Field Defect Location. J Glaucoma. 2017 Dec;26(12):1120–1129. doi: 10.1097/IJG.0000000000000800.Savastano MC, Lumbroso B, Rispoli M. In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2196–2203. doi: 10.1097/IAE.0000000000000635.Savastano MC, Lumbroso B, Rispoli M. In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2196–2203. doi: 10.1097/IAE.0000000000000635.Курышева Н.И., Маслова Е.В., Трубилина А.В., Фомин А.В. ОКТ-ангиография и цветовое допплеровское картирование в исследовании гемоперфузии сетчатки и зрительного нерва при глаукоме. Офтальмология. 2016;13(2):102–110. doi: 10.18008/1816-5095-2016-2-102-110.Kurysheva NI, Maslova EV, Trubilina AV, Fomin AV. OCT angiography and Color Doppler Imaging in the study of hemoperfusion in the retina and optic nerve in POAG. Ophthalmology in Russia. 2016;13(2):102–110 (In Russ.). doi: 10.18008/1816-5095-2016-2-102-110.Lee J, Park CK, Park HL. Determinants of vessel defects in superficial and deep vascular layers in normal-tension glaucoma using optical coherence tomography angiography. Sci Rep. 2021 May 11;11(1):9941. doi: 10.1038/s41598-021-89428-5.Lee J, Park CK, Park HL. Determinants of vessel defects in superficial and deep vascular layers in normal-tension glaucoma using optical coherence tomography angiography. Sci Rep. 2021 May 11;11(1):9941. doi: 10.1038/s41598-021-89428-5.Xu H, Zhai R, Zong Y, Kong X, Jiang C, Sun X, He Y, Li X. Comparison of retinal microvascular changes in eyes with high-tension glaucoma or normal-tension glaucoma: a quantitative optic coherence tomography angiographic study. Graefes Arch Clin Exp Ophthalmol. 2018 Jun;256(6):1179–1186. doi: 10.1007/s00417-018-3930-z.Xu H, Zhai R, Zong Y, Kong X, Jiang C, Sun X, He Y, Li X. Comparison of retinal microvascular changes in eyes with high-tension glaucoma or normal-tension glaucoma: a quantitative optic coherence tomography angiographic study. Graefes Arch Clin Exp Ophthalmol. 2018 Jun;256(6):1179–1186. doi: 10.1007/s00417-018-3930-z.Mursch-Edlmayr AS, Waser K, Podkowinski D, Bolz M. Differences in sweptsource OCT angiography of the macular capillary network in high tension and normal tension glaucoma. Curr Eye Res. 2020 Sep;45(9):1168–1172. doi: 10.1080/02713683.2020.1722178.Mursch-Edlmayr AS, Waser K, Podkowinski D, Bolz M. Differences in sweptsource OCT angiography of the macular capillary network in high tension and normal tension glaucoma. Curr Eye Res. 2020 Sep;45(9):1168–1172. doi: 10.1080/02713683.2020.1722178.Toshev AP, Schuster AK, Ul Hassan SN, Pfeiffer N, Hoffmann EM. Optical Coherence Tomography Angiography of Optic Disc in Eyes With Primary Open-angle Glaucoma and Normal-tension Glaucoma. J Glaucoma. 2019 Mar;28(3):243–251. doi: 10.1097/IJG.0000000000001184. PMID: 30624391.Toshev AP, Schuster AK, Ul Hassan SN, Pfeiffer N, Hoffmann EM. Optical Coherence Tomography Angiography of Optic Disc in Eyes With Primary Open-angle Glaucoma and Normal-tension Glaucoma. J Glaucoma. 2019 Mar;28(3):243–251. doi: 10.1097/IJG.0000000000001184. PMID: 30624391.Lin YH, Huang SM, Yeung L, Ku WC, Chen HS, Lai CC, Chuang LH. Correlation of Visual Field With Peripapillary Vessel Density Through Optical Coherence Tomography Angiography in Normal-Tension Glaucoma. Transl Vis Sci Technol. 2020 Dec 17;9(13):26. doi: 10.1167/tvst.9.13.26.Lin YH, Huang SM, Yeung L, Ku WC, Chen HS, Lai CC, Chuang LH. Correlation of Visual Field With Peripapillary Vessel Density Through Optical Coherence Tomography Angiography in Normal-Tension Glaucoma. Transl Vis Sci Technol. 2020 Dec 17;9(13):26. doi: 10.1167/tvst.9.13.26.Shin JW, Lee JY, Lee BJ, Lim HT, Kook MS. Clinical characteristics of choroidal microvasculature dropout in normal-tension glaucoma versus nonarteritic anterior ischemic optic neuropathy: an optical coherence tomography angiography study. Sci Rep. 2021 Nov 1;11(1):21391. doi: 10.1038/s41598-021-00868-5.Shin JW, Lee JY, Lee BJ, Lim HT, Kook MS. Clinical characteristics of choroidal microvasculature dropout in normal-tension glaucoma versus nonarteritic anterior ischemic optic neuropathy: an optical coherence tomography angiography study. Sci Rep. 2021 Nov 1;11(1):21391. doi: 10.1038/s41598-021-00868-5.Jung Y, Park HL, Shin H, Oh SE, Kim SA, Lee JY, Shin DY, Jeon SJ, Kim YC, Shin HY, Choi JA, Lee NY, Park CK. Microvasculature Dropout and Development of Normal Tension Glaucoma in Glaucoma Suspects: The Normal Tension Glaucoma Suspect Cohort Study. Am J Ophthalmol. 2022 Nov;243:135–148. doi: 10.1016/j.ajo.2022.07.020.Jung Y, Park HL, Shin H, Oh SE, Kim SA, Lee JY, Shin DY, Jeon SJ, Kim YC, Shin HY, Choi JA, Lee NY, Park CK. Microvasculature Dropout and Development of Normal Tension Glaucoma in Glaucoma Suspects: The Normal Tension Glaucoma Suspect Cohort Study. Am J Ophthalmol. 2022 Nov;243:135–148. doi: 10.1016/j.ajo.2022.07.020.Lee S.H., Kim T.W., Lee E.J., Girard, M.J.A. Focal lamina cribrosa defects are not associated with steep lamina cribrosa curvature but with choroidal microvascular dropout. Scientific reports. 2020;10:6761. https://doi.org/10.1038/s41598-020-63681-6.Lee S.H., Kim T.W., Lee E.J., Girard, M.J.A. Focal lamina cribrosa defects are not associated with steep lamina cribrosa curvature but with choroidal microvascular dropout. Scientific reports. 2020;10:6761. https://doi.org/10.1038/s41598-020-63681-6.Sun Y, Guo Y, Xie Y, Cao K, Liu X, Yang Y, Shi Y, Fan S, Wang H, Wang N. Intereye Comparison of Focal Lamina Cribrosa Defect in Normal-Tension Glaucoma Patients with Asymmetric Visual Field Loss. Ophthalmic Res. 2021;64(3):447–457. doi: 10.1159/000512925.Sun Y, Guo Y, Xie Y, Cao K, Liu X, Yang Y, Shi Y, Fan S, Wang H, Wang N. Intereye Comparison of Focal Lamina Cribrosa Defect in Normal-Tension Glaucoma Patients with Asymmetric Visual Field Loss. Ophthalmic Res. 2021;64(3):447–457. doi: 10.1159/000512925.Li T, Lindsley K, Rouse B, Hong H, Shi Q, Friedman DS, Wormald R, Dickersin K. Comparative Effectiveness of First-Line Medications for Primary Open-Angle Glaucoma: A Systematic Review and Network Meta-analysis. Ophthalmology. 2016 Jan;123(1):129–140. doi: 10.1016/j.ophtha.2015.09.005.Li T, Lindsley K, Rouse B, Hong H, Shi Q, Friedman DS, Wormald R, Dickersin K. Comparative Effectiveness of First-Line Medications for Primary Open-Angle Glaucoma: A Systematic Review and Network Meta-analysis. Ophthalmology. 2016 Jan;123(1):129–140. doi: 10.1016/j.ophtha.2015.09.005.Kim JM, Sung KR, Kim HK, Park SW, Lee EJ, Jeoung JW, Park HL, Ahn J, Yoo C, Kim CY. Long-Term Effectiveness and Safety of Tafluprost, Travoprost, and Latanoprost in Korean Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma: A Multicenter Retrospective Cohort Study (LOTUS Study). J Clin Med. 2021 Jun 19;10(12):2717. doi: 10.3390/jcm10122717.Kim JM, Sung KR, Kim HK, Park SW, Lee EJ, Jeoung JW, Park HL, Ahn J, Yoo C, Kim CY. Long-Term Effectiveness and Safety of Tafluprost, Travoprost, and Latanoprost in Korean Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma: A Multicenter Retrospective Cohort Study (LOTUS Study). J Clin Med. 2021 Jun 19;10(12):2717. doi: 10.3390/jcm10122717.Kitamura K, Chiba T, Mabuchi F, Ishijima K, Omoto S, Kashiwagi F, Godo T, Kogure S, Goto T, Shibuya T, Tanabe J, Tsukahara S, Tsuchiya T, Tsumura T, Tokunaga T, Hosaka O, Saito T, Kashiwagi K. Efficacy and Safety of Switching Prostaglandin Analog Monotherapy to Tafluprost/Timolol Fixed-Combination Therapy. J Ophthalmol. 2018 Feb 21;2018:8456764. doi: 10.1155/2018/8456764.Kitamura K, Chiba T, Mabuchi F, Ishijima K, Omoto S, Kashiwagi F, Godo T, Kogure S, Goto T, Shibuya T, Tanabe J, Tsukahara S, Tsuchiya T, Tsumura T, Tokunaga T, Hosaka O, Saito T, Kashiwagi K. Efficacy and Safety of Switching Prostaglandin Analog Monotherapy to Tafluprost/Timolol Fixed-Combination Therapy. J Ophthalmol. 2018 Feb 21;2018:8456764. doi: 10.1155/2018/8456764.Kim TW, Kim M, Lee EJ, Jeoung JW, Park KH. Intraocular pressure-lowering efficacy of dorzolamide/timolol fixed combination in normal-tension glaucoma. J Glaucoma. 2014 Jun-Jul;23(5):329–332. doi: 10.1097/IJG.0b013e3182741f4d.Kim TW, Kim M, Lee EJ, Jeoung JW, Park KH. Intraocular pressure-lowering efficacy of dorzolamide/timolol fixed combination in normal-tension glaucoma. J Glaucoma. 2014 Jun-Jul;23(5):329–332. doi: 10.1097/IJG.0b013e3182741f4d.Park SW, Kim JM, Lee JW, Maglambayan J, Simonyi S, Park KH. Efficacy and safety of fixed-combination brimonidine tartrate/timolol maleate in primary openangle glaucoma, including normal-tension glaucoma. Jpn J Ophthalmol. 2021 Mar;65(2):295–305. doi: 10.1007/s10384-020-00796-3.Park SW, Kim JM, Lee JW, Maglambayan J, Simonyi S, Park KH. Efficacy and safety of fixed-combination brimonidine tartrate/timolol maleate in primary openangle glaucoma, including normal-tension glaucoma. Jpn J Ophthalmol. 2021 Mar;65(2):295–305. doi: 10.1007/s10384-020-00796-3.Курышева Н.И. Ингибиторы карбоангидразы в лечении глаукомы. Обзор. Часть 1. Офтальмология. 2020;17(3s):542–549. doi: 10.18008/1816-5095-2020-3S-542-549.Kurysheva NI. Carbonic Anhydrase Inhibitors in the Treatment of Glaucoma. Review. Part I. Ophthalmology in Russia. 2020;17(3s):542–549. (In Russ.)]. doi: 10.18008/1816-5095-2020-3S-542-549.Курышева Н.И. Ингибиторы карбоангидразы в лечении глаукомы. Обзор. Часть 2. Офтальмология. 2020;17(4):676–682. doi: 10.18008/1816-5095-2020-4-676-682.Kurysheva NI. Carbonic Anhydrase Inhibitors in the Treatment of Glaucoma. Review. Part II. Ophthalmology in Russia. 2020;17(4):676–682 (In Russ.)]. doi: 10.18008/1816-5095-2020-4-676-682.Iester M. Brinzolamide ophthalmic suspension: a review of its pharmacology and use in the treatment of open angle glaucoma and ocular hypertension. Clin Ophthalmol. 2008 Sep;2(3):517–523. doi: 10.2147/opth.s3182.Iester M. Brinzolamide ophthalmic suspension: a review of its pharmacology and use in the treatment of open angle glaucoma and ocular hypertension. Clin Ophthalmol. 2008 Sep;2(3):517–523. doi: 10.2147/opth.s3182.Petropoulos IK, Pournaras JA, Munoz JL, Pournaras CJ. Effect of acetazolamide on the optic disc oxygenation in miniature pigs. Klin Monbl Augenheilkd. 2004 May;221(5):367–370. doi: 10.1055/s-2004-812816.Petropoulos IK, Pournaras JA, Munoz JL, Pournaras CJ. Effect of acetazolamide on the optic disc oxygenation in miniature pigs. Klin Monbl Augenheilkd. 2004 May;221(5):367–370. doi: 10.1055/s-2004-812816.Reber F, Gersch U, Funk RW. Blockers of carbonic anhydrase can cause increase of retinal capillary diameter, decrease of extracellular and increase of intracellular pH in rat retinal organ culture. Graefes Arch Clin Exp Ophthalmol. 2003 Feb;241(2):140–148. doi: 10.1007/s00417-002-0560-1.Reber F, Gersch U, Funk RW. Blockers of carbonic anhydrase can cause increase of retinal capillary diameter, decrease of extracellular and increase of intracellular pH in rat retinal organ culture. Graefes Arch Clin Exp Ophthalmol. 2003 Feb;241(2):140–148. doi: 10.1007/s00417-002-0560-1.Martínez A, Sánchez M. A comparison of the effects of 0.005% latanoprost and fixed combination dorzolamide/timolol on retrobulbar haemodynamics in previously untreated glaucoma patients. Curr Med Res Opin. 2006 Jan;22(1):67–73. doi: 10.1185/030079906X80215.Martínez A, Sánchez M. A comparison of the effects of 0.005% latanoprost and fixed combination dorzolamide/timolol on retrobulbar haemodynamics in previously untreated glaucoma patients. Curr Med Res Opin. 2006 Jan;22(1):67–73. doi: 10.1185/030079906X80215.Курышева Н.И., Апостолова А.С., Иртегова Е.Ю., Киселева Т.Н. Бринзоламид/ тимолол и латанопрост в лечении псевдоэксфолиативной глаукомы: сравнительное исследование. Национальный журнал Глаукома. 2014;13(3):52–62.Kurysheva NI, Apostolova AS, Irtegova EYu, Kiseleva TN. Brinzolamid/timolol and latanoprost in pseudoexfoliative glaucoma: a comparative study. National Journal glaucoma. 2014;13(3):52–62 (In Russ.).Iester M, Altieri M, Michelson G, Vittone P, Traverso CE, Calabria G. Retinal peripapillary blood flow before and after topical brinzolamide. Ophthalmologica. 2004 Nov-Dec;218(6):390–396. doi: 10.1159/000080942.Iester M, Altieri M, Michelson G, Vittone P, Traverso CE, Calabria G. Retinal peripapillary blood flow before and after topical brinzolamide. Ophthalmologica. 2004 Nov-Dec;218(6):390–396. doi: 10.1159/000080942.Arend O, Harris A, Wolter P, Remky A. Evaluation of retinal haemodynamics and retinal function after application of dorzolamide, timolol and latanoprost in newly diagnosed open-angle glaucoma patients. Acta Ophthalmol Scand. 2003 Oct;81(5):474–479. doi: 10.1034/j.1600-0420.2003.00122.x.Arend O, Harris A, Wolter P, Remky A. Evaluation of retinal haemodynamics and retinal function after application of dorzolamide, timolol and latanoprost in newly diagnosed open-angle glaucoma patients. Acta Ophthalmol Scand. 2003 Oct;81(5):474–479. doi: 10.1034/j.1600-0420.2003.00122.x.Conti F, Romano GL, Eandi CM, Toro MD, Rejdak R, Di Benedetto G, Lazzara F, Bernardini R, Drago F, Cantarella G, Bucolo C. Brimonidine is Neuroprotective in Animal Paradigm of Retinal Ganglion Cell Damage. Front Pharmacol. 2021 Jul 21;12:705405. doi: 10.3389/fphar.2021.705405.Conti F, Romano GL, Eandi CM, Toro MD, Rejdak R, Di Benedetto G, Lazzara F, Bernardini R, Drago F, Cantarella G, Bucolo C. Brimonidine is Neuroprotective in Animal Paradigm of Retinal Ganglion Cell Damage. Front Pharmacol. 2021 Jul 21;12:705405. doi: 10.3389/fphar.2021.705405.Курышева Н.И. Селективные α2-агонисты в лечении глаукомы: фармакологические свойства, эффективность и безопасность. Вестник офтальмологии. 2019;135(2):144–150. doi: 10.17116/oftalma2019135021144Kurysheva NI. Selective α2-agonists in the treatment of glaucoma: pharmacology, efficacy and safety. Annals of Ophthalmology 2019;135(2):144–150 (In Russ.)]. doi: 10.17116/oftalma2019135021144Lee JWY, Chan PP, Zhang X, Chen LJ, Jonas JB. Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management. Asia Pac J Ophthalmol (Phila). 2019 Nov-Dec;8(6):457–468. doi: 10.1097/01.APO.0000605096.48529.9c.Lee JWY, Chan PP, Zhang X, Chen LJ, Jonas JB. Latest Developments in Normal-Pressure Glaucoma: Diagnosis, Epidemiology, Genetics, Etiology, Causes and Mechanisms to Management. Asia Pac J Ophthalmol (Phila). 2019 Nov-Dec;8(6):457–468. doi: 10.1097/01.APO.0000605096.48529.9c.Esporcatte BL, Tavares IM. Normal-tension glaucoma: an update. Arq Bras Oftalmol. 2016 Jul-Aug;79(4):270–276. doi: 10.5935/0004-2749.20160077.Esporcatte BL, Tavares IM. Normal-tension glaucoma: an update. Arq Bras Oftalmol. 2016 Jul-Aug;79(4):270–276. doi: 10.5935/0004-2749.20160077.Tribble JR, Otmani A, Sun S, Ellis SA, Cimaglia G, Vohra R, Jöe M, Lardner E, Venkataraman AP, Domínguez-Vicent A, Kokkali E, Rho S, Jóhannesson G, Burgess RW, Fuerst PG, Brautaset R, Kolko M, Morgan JE, Crowston JG, Votruba M, Williams PA. Nicotinamide provides neuroprotection in glaucoma by protecting against mitochondrial and metabolic dysfunction. Redox Biol. 2021 Jul;43:101988. doi: 10.1016/j.redox.2021.101988.Tribble JR, Otmani A, Sun S, Ellis SA, Cimaglia G, Vohra R, Jöe M, Lardner E, Venkataraman AP, Domínguez-Vicent A, Kokkali E, Rho S, Jóhannesson G, Burgess RW, Fuerst PG, Brautaset R, Kolko M, Morgan JE, Crowston JG, Votruba M, Williams PA. Nicotinamide provides neuroprotection in glaucoma by protecting against mitochondrial and metabolic dysfunction. Redox Biol. 2021 Jul;43:101988. doi: 10.1016/j.redox.2021.101988.Martucci A, Mancino R, Cesareo M, Pinazo-Duran MD, Nucci C. Combined use of coenzyme Q10 and citicoline: A new possibility for patients with glaucoma. Front Med (Lausanne). 2022 Dec 15;9:1020993. doi: 10.3389/fmed.2022.1020993.Martucci A, Mancino R, Cesareo M, Pinazo-Duran MD, Nucci C. Combined use of coenzyme Q10 and citicoline: A new possibility for patients with glaucoma. Front Med (Lausanne). 2022 Dec 15;9:1020993. doi: 10.3389/fmed.2022.1020993.Wong MO, Lee JW, Choy BN, Chan JC, Lai JS. Systematic review and metaanalysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Surv Ophthalmol. 2015 Jan-Feb;60(1):36–50. doi: 10.1016/j.survophthal.2014.06.006.Wong MO, Lee JW, Choy BN, Chan JC, Lai JS. Systematic review and metaanalysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Surv Ophthalmol. 2015 Jan-Feb;60(1):36–50. doi: 10.1016/j.survophthal.2014.06.006.Lee JWY, Liu CCL, Chan JCH, Lai JSM. Predictors of success in selective laser trabeculoplasty for normal tension glaucoma. Medicine (Baltimore). 2014 Dec;93(28):e236. doi: 10.1097/MD.0000000000000236.Lee JWY, Liu CCL, Chan JCH, Lai JSM. Predictors of success in selective laser trabeculoplasty for normal tension glaucoma. Medicine (Baltimore). 2014 Dec;93(28):e236. doi: 10.1097/MD.0000000000000236.Lee JW, Ho WL, Chan JC, Lai JS. Efficacy of selective laser trabeculoplasty for normal tension glaucoma: 1 year results. BMC Ophthalmol. 2015 Jan 8;15:1. doi: 10.1186/1471-2415-15-1.Lee JW, Ho WL, Chan JC, Lai JS. Efficacy of selective laser trabeculoplasty for normal tension glaucoma: 1 year results. BMC Ophthalmol. 2015 Jan 8;15:1. doi: 10.1186/1471-2415-15-1.Suominen S, Harju M, Kurvinen L, Vesti E. Deep sclerectomy in normal-tension glaucoma with and without mitomycin-c. Acta Ophthalmol. 2014 Nov;92(7):701–706. doi: 10.1111/aos.12305.Suominen S, Harju M, Kurvinen L, Vesti E. Deep sclerectomy in normal-tension glaucoma with and without mitomycin-c. Acta Ophthalmol. 2014 Nov;92(7):701–706. doi: 10.1111/aos.12305.Harju M, Suominen S, Allinen P, Vesti E. Long-term results of deep sclerectomy in normal-tension glaucoma. Acta Ophthalmol. 2018 Mar;96(2):154–160. doi: 10.1111/aos.13529.Harju M, Suominen S, Allinen P, Vesti E. Long-term results of deep sclerectomy in normal-tension glaucoma. Acta Ophthalmol. 2018 Mar;96(2):154–160. doi: 10.1111/aos.13529.Lai C, Shao SC, Chen YH, Kuo YK, Lai CC, Chuang LH. Trabeculectomy With Antimetabolite Agents for Normal Tension Glaucoma: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 Jun 28;9:932232. doi: 10.3389/fmed.2022.932232.Lai C, Shao SC, Chen YH, Kuo YK, Lai CC, Chuang LH. Trabeculectomy With Antimetabolite Agents for Normal Tension Glaucoma: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 Jun 28;9:932232. doi: 10.3389/fmed.2022.932232.

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