ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2025-4-764-770ophthalmology-2802Research ArticleОБЗОРЫREVIEWSЗакрытоугольная глаукома с псевдоплоской радужкой на фоне кист цилиарного тела: обзор литературы и наш клинический опытAngle-closure Glaucoma Due to Ciliary Body Cysts and Ppseudoplateau Iris: A Systematic Review of the Literature and Clinical Casehttps://orcid.org/0009-0009-3728-6763УсановаГ. Ю.UsanovaG. Yu.

Усанова Галина Юрьевна - младший научный сотрудник отдела хирургии глаукомы.

Бескудниковский бульвар, 59а, стр. 1, Москва, 127486

Usanova Galina Yu. junior research officer of the Glaucoma Surgery Department.

Beskudnikovsky ave., 59a, bld. 1, Moscow, 127486

УзунянД. Г.UzunyanDh. G.

Узунян Джульетта Григорьевна - кандидат медицинских наук, врач офтальмолог клинико-экспертного отдела, врач высшей категории.

Бескудниковский бульвар, 59а, стр. 1, Москва, 127486

Uzunyan Dhulietta G. - PhD, ophthalmologist of Clinical-Expert Department, doctor of higher category.

Beskudnikovsky ave., 59a, bld. 1, Moscow, 127486

https://orcid.org/0009-0003-3576-4991БайтоковаТ. М.BaytokovaT. M.

Байтокова Талифа Муратовна - врач-офтальмолог, ординатор.

Бескудниковский бульвар, 59а, стр. 1, Москва, 127486

Baytokova Talifa M. - ophthalmologist, resident.

Beskudnikovsky ave., 59a, bld. 1, Moscow, 127486

АнтоноваО. П.AntonovaO. P.

Антонова Ольга Павловна - кандидат медицинских наук, научный сотрудник отдела трансплантационной и оптико-реконструктивной хирургии переднего отрезка глазного яблока.

Бескудниковский бульвар, 59а, стр. 1, Москва, 127486

Antonova Olga P. - PhD, researcher of the Department of Transplanting and Opto-Reconstructive Surgery of the Anterior Segment of the Eyeball.

Beskudnikovsky ave., 59a, bld. 1, Moscow, 127486

ФГАУ НМИЦ «МНТК “Микрохирургия глаза” им. академика С.Н. Федорова» Министерства здравоохранения Российской ФедерацииРоссияS. Fyodorov Eye Microsurgery Federal State InstitutionRussian Federation202528122025224764770Copyright © Усанова Г.Ю., Узунян Д.Г., Байтокова Т.М., Антонова О.П., 20252025Усанова Г.Ю., Узунян Д.Г., Байтокова Т.М., Антонова О.П.Usanova G.Y., Uzunyan D.G., Baytokova T.M., Antonova O.P.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/2802

Статья представляет собой обзор отечественной и зарубежной литературы, посвященной проблеме закрытоугольной глаукомы (ЗУГ) с псевдоплоской радужкой, возникающей на фоне первичных иридоцилиарных кист, а также методам диагностики и лечения. Было проанализировано 46 источников отечественной и зарубежной литературы по актуальной нозологии. Для выявления кист цилиарного тела необходимо своевременное клиническое обследование и высокий индекс подозрительности у пациентов с атипичным строением узких или закрытых углов передней камеры, особенно у пациентов молодого возраста без предшествующей травмы или хирургического вмешательства. Исходя из патогенетических механизмов развития заболевания закономерно утверждение, что проведение лазерной иридэктомии в большинстве случаев не приводит к раскрытию угла передней камеры и не может рекомендоваться как метод выбора. По данным литературы, в настоящее время нет единого мнения о наиболее эффективных и безопасных методах лечения, а методом выбора у данных пациентов является широкий диапазон вмешательств, включающий медикаментозное, лазерное и хирургическое лечение в зависимости от обширности поражения цилиарного тела кистами и стадии заболевания. В литературе не удалось обнаружить рекомендации по профилактике развития закрытоугольной глаукомы на фоне наличия высокого риска и предикторов заболевания. Представлен клинический случай наследственной двусторонней офтальмогипертензии, ассоциированной с билатеральными множественными кистами иридоцилиарных отростков. Изменение ультразвуковых показателей биомикроскопии переднего отрезка глаза и данные клинических наблюдений после проведения у пациента рефракционной ленсэктомии позволяют предположить, что своевременное проведение хирургического вмешательства у данной категории пациентов позволяет не только улучшить качество жизни, но и снизить риск развития глаукомы. Для окончательных выводов требуются более длительные сроки наблюдения.

The article is a review of domestic and foreign literature devoted to the problem of angle-closure glaucoma (ACG) associated with pseudoplateau iris due to multiple iridociliary cysts, in addition, diagnostic and treatment methods were considered. The analysis of 46 sources on current nosology was carried out on the basis of data from domestic and foreign literature. Timely clinical examination and detection of a high index of suspicion in patients with an atypical structure of narrow or closed corners of the anterior chamber, especially in young patients without previous trauma or surgery, to identify ciliary body cysts is necessary. Based on the pathogenetic mechanisms of the disease, it is natural to make the statement, that laser iridectomy in most cases does not lead to the opening of the anterior chamber angle and cannot be recommended as the therapy of choice. According to published sources, there is currently no consensus on the most effective and safe treatment methods, and the therapy of choice for these patients is a wide range of interventions, including medication, laser and surgical treatment, depending on the extent of damage to the ciliary body by cysts and the stage of the disease. According to the literature data, we were unable to find recommendations for the prevention of the development of angle-closure glaucoma on the background of high risk and predictors of this disease. We present a clinical case of genetic bilateral ophthalmohypertension caused by bilateral multiple cysts of iridociliary processes. Changes in ultrasound parameters of biomicroscopy of the anterior segment of the eye and clinical observations after refractive lancetectomy suggest, that timely surgical intervention can improve the quality of life and reduce the risk of glaucoma in this category of patients. Longer observation periods are required for final conclusions.

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