Novosti
Khirurgii

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Year 2017 Vol. 25 No 3

REVIEWS

I.R. SALDAN 1, A.V. ARTEMOV 2, Y.I. SALDAN 1, G.G. NAZARCHUK 1,S.V. VERNYHORODSKYI 1

TO THE PROBLEM OF ETIOPATHOGENESIS OF THE PRIMARY OPEN ANGLE GLAUCOMA

Vinnitsa National Medical University named after N.I.Pirogov1.
Vinnytsia
SE "Filatov Institute of Eye Diseases and Tissue Therapy"2 of the NAMS of Ukraine
Odessa
Ukraine

Degeneration of the endothelium of the anterior chamber and the drainage system of the eye is one of the key elements of etiopathogenesis of the primary open-angle glaucoma (POAG). Morphological, histogenetic and functional alliance of the corneal endothelium and trabecular meshwork, visible only by electronic microscopy, indicates a unified charaeter of the pathologicul changes. Such approach permits to see the general etiopathogenetic mechanism of age-related pathology in the trabecular zone, leading to POAG, and in the posterior corneal epithelium resulted in the bullous keratopathy.
Insufficient number of endothelial cells lining the trabecular meshwork loses its ability to hold the intraocular fluid and initiates the process of similar bullous keratopathy. Swelling of trabecular collagen fibers leads to the narrowing of the inter-trabecular gaps’ lumen and the increase of resistance to intraocular fluid outflow.
A hypothesis of POAG pathogenesis based on the unity of histogenesis and morphological composition of the trabecular structures and the posterior segment of the cornea («Dua’s layer») is proposed. The main reason of these pathological changes is considered to be an age-related reduction of the endothelial cell density. Thus, the common nature of the pathological changes leading to glaucoma, keratoconus, bullous keratopathy is grounded, based on the proximity of the composition and functions of these structures.

Keywords: open-angle glaucoma, etiology, pathogenesis, trabecular meshwork, endothelium, keratoconus, bullous keratopathy
p. 300-305 of the original issue
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Address for correspondence:
21018, Ukraine, Vinnitsa, Pirogov str., 56, Vinnytsia National Medical University named after NI Pirogov,
Department of eye diseases

Email:shepelyuk.g.g@gmail.com,
Galina G. Nazarchuk
Information about the authors:
Saldan I.R. MD, Professor of department of eye diseases, Vinnytsia National Medical University named after N.I.Pirogov..
Artemov A.V. PhD, supervisor of laboratory of pathologic anatomy and donor’s tissues conservation of SE "V.P.Filatov Institute of eye diseases and tissue therapy of NAMSU".
Saldan Y.Y. PhD, Ass. Professor of department of eye diseases, Vinnytsia National Medical University named after N.I.Pirogov.
Nazarchuk G.G. PhD, Assistant of department of eye diseases, Vinnytsia National Medical University named after N.I.Pirogov.
Vernyhorodskyi S.V. MD, Professor of department of pathologic anatomy, Vinnytsia National Medical University named after N.I. Pirogov.
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