helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2026-19-2-118-125helmholtzeyeinstitute-2175Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESКлинический анализ параметров васкуляризации фильтрационных подушек после синустрабекулэктомии по томографическим изображениям с использованием методов машинного зренияClinical analysis of trabeculectomy filtering bleb vascularization parameters based on tomographic images using machine vision methodshttps://orcid.org/0000-0001-6922-0464ПетровС. Ю.PetrovS. Yu.

Петров Сергей Юрьевич — д-р мед. наук, начальник отдела глаукомы.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Sergey Yu. Petrov — Dr. of Med. Sci., head of glaucoma department.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

glaucomatosis@gmail.comhttps://orcid.org/0000-0001-5533-214XСолодовниковВ. И.SolodovnikovV. I.

Солодовников Владимир Игоревич — канд. техн. наук, директор.

ул. Маршала Бирюзова, д. 7а, Одинцово, Московская область, 143000

Vladimir I. Solodovnikov — Cand. of Techn. Sci., director.

7A, Marshal Biryuzov St., Odintsovo, Moscow Region, 143000

https://orcid.org/0000-0002-3553-9896МилашС. В.MilashS. V.

Милаш Сергей Викторович — канд. мед. наук, старший научный сотрудник отдела патологии рефракции, бинокулярного зрения и офтальмоэргономики.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Sergei V. Milash — Cand. of Med. Sci., senior researcher, department of refraction pathology, binocular vision and ophthalmoergonomics.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

https://orcid.org/0000-0002-8090-6034МаркеловаО. И.MarkelovaO. I.

Маркелова Оксана Игоревна — младший научный сотрудник отдела глаукомы.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Oksana I. Markelova — junior researcher, glaucoma department.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

https://orcid.org/0009-0006-8100-9681ЕпхиеваА. Д.EpkhievaA. D.

Епхиева Анжела Давидовна — аспирант отдела глаукомы.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Anzhela D. Epkhieva — PhD, glaucoma department.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

https://orcid.org/0009-0006-9009-6545ПавловК. В.PavlovK. V.

Павлов Кирилл Владиславович — аспирант отдела глаукомы.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Kirill V. Pavlov — PhD, glaucoma department.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

КаракотоваН. В.KarakotovaN. V.

Каракотова Наталья Владимировна — студент.

2-я Бауманская улица, д. 5, стр. 4, Москва, 105055

Natalya V. Karakotova — student.

5, Build. 4, 2nd Baumanskaya St., Moscow,105055

ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian FederationФГБУ науки «Центр информационных технологий в проектировании» Российской академии наукРоссияDesign Information Technologies Center of Russian Academy of SciencesRussian FederationФГАОУ ВО «Московский государственный технический университет им. Н.Э. Баумана»РоссияBauman Moscow State Technical UniversityRussian Federation202618072026192118125Copyright © Петров С.Ю., Солодовников В.И., Милаш С.В., Маркелова О.И., Епхиева А.Д., Павлов К.В., Каракотова Н.В., 20262026Петров С.Ю., Солодовников В.И., Милаш С.В., Маркелова О.И., Епхиева А.Д., Павлов К.В., Каракотова Н.В.Petrov S.Y., Solodovnikov V.I., Milash S.V., Markelova O.I., Epkhieva A.D., Pavlov K.V., Karakotova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/2175

Состояние фильтрационной подушки (ФП) во многом определяет гипотензивный эффект фистулизирующего антиглаукомного вмешательства. Цель работы — проведение клинического анализа параметров васкуляризации ФП после синустрабекулэктомии (СТЭ) по томографическим изображениям с использованием методов машинного зрения. Материал и методы. В исследование включено 83 пациента (100 глаз) в возрасте от 57 до 81 года с первичной открытоугольной глаукомой развитой и далеко зашедшей стадий с выполненной СТЭ по стандартной методике. Проводили фотографию биомикроскопической картины и оптическую когерентную томографию с ангиографией фильтрационной зоны до операции, спустя 1, 2 и 6 нед после нее. Контроль уровня офтальмотонуса осуществляли в указанные сроки бесконтактным пневмотонометром. По томографическому изображению операционной зоны рассчитывали показатели плотности сосудистой сети, извитости сосудов и степени гиперемии. Результаты. Показатели всех оцениваемых параметров ФП в различной степени увеличиваются к 1-й неделе после операции с тенденцией к нормализации к концу 6-й недели. Наибольшие изменения претерпевают плотность сосудистой сети и степень поверхностной гиперемии. Отмечена корреляция высокой степени между сосудистой плотностью и гиперемией во все сроки наблюдения, а также значимая корреляционная взаимосвязь между уровнем послеоперационного внутриглазного давления и плотностью сосудистой сети со 2-й недели наблюдения с тенденцией к увеличению силы связи к 6-й неделе. Заключение. Разработка комбинированного программного метода определения степени васкуляризации и извитости сосудистой сети ФП, а также гиперемии по томографическим изображениям с использованием методов машинного зрения может послужить основой для оценки эффективности хирургического лечения глаукомы.

The shape of the filtration bleb (FB) largely determines the hypotensive effect of glaucoma surgery. Purpose: to conduct a clinical analysis of the vascularization parameters of FB after trabeculectomy based on tomographic images using machine vision techniques. Material and methods. 83 patients (100 eyes) aged 57 to 81 years with moderate and advanced primary open-angle glaucoma underwent trabeculectomy using the standard technique. Biomicroscopic photography and optical coherence tomography with angiography of the filtration zone were performed preoperatively and at 1, 2, and 6 weeks postoperatively. IOP levels were monitored using a contactless pneumotonometer. Vascular network density, vascular tortuosity, and the degree of hyperemia were assessed using the tomographic image of the surgical area. Results. All assessed FB parameters increased to varying degrees by 1 week postoperatively, with a tendency to normalize by 6 weeks. Vascular density and the degree of superficial hyperemia experienced the greatest changes. A high correlation was observed between vascular density and hyperemia at all follow-up periods, as well as a significant correlation between postoperative IOP and vascular density beginning in the 2nd week of follow-up, with a tendency toward increased strength by 6 weeks. Conclusion. The development of a combined software method for determining the degree of vascularization and tortuosity of the FB vascular network, as well as hyperemia, using tomographic images and machine vision techniques can serve as a basis for assessing the effectiveness of glaucoma surgical treatment.

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