helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2019-12-4-35-42helmholtzeyeinstitute-335Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESАнализ циркадианного ритма внутриглазного давления при стабильной и прогрессирующей формах первичной открытоугольной глаукомыAnalysis of the circadian rhythm of intraocular pressure in stable and progressive forms of primary open-angle glaucomaМалишевскаяТ. Н.MalishevskayaT. N.

д-р мед. наук, врач-офтальмолог

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

Dr. of Med. Sci., ophthalmologist

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

malishevskoff@yandex.ruГубинД. Г.GubinD. G.

д-р мед. наук, профессор

ул. Одесская, д. 54, Тюмень, 625023, Россия

Dr. of Med. Sci., Professor

54, Odesskaya St., Tyumen, 625023, Russia

НемцоваИ. В.NemcovaI. V.

врач-офтальмолог

ул. Холодильная, д. 118/1, Тюмень, 625048, Россия

ophthalmologist

118/1, Kholodilnaja St., Tyumen, 625048, Russia

ВласоваА. С.VlasovaA. S.

врач-офтальмолог

ул. Холодильная, д. 118/1, Тюмень, 625048, Россия

ophthalmologist

118/1, Kholodilnaja St., Tyumen, 625048, Russia

ФилипповаЮ. Е.FilippovaJu. E.

врач-офтальмолог

ул. Холодильная, д. 118/1, Тюмень, 625048, Россия

ophthalmologist

118/1, Kholodilnaja St., Tyumen, 625048, Russia

ФариковаЭ. Э.FarikovaE. E.

врач-офтальмолог

ул. Льва Толстого, д. 6-8, Санкт-Петербург, 197022, Россия

ophthalmologist

6-8, L'va Tolstogo St., St. Petersburg, 197022, Russia

БогдановаД. С.BogdanovaD. S.

студентка 6-го курса

ул. Одесская, д. 54, Тюмень, 625023, Россия

6th year student

54, Odesskaya St., Tyumen, 625023, Russia

ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian FederationФГБОУ ВО «Тюменский ГМУ»РоссияTyumen State Medical UniversityRussian FederationГАУЗ ТО «Областной офтальмологический диспансер»РоссияRegional Ophthalmologic ClinicRussian FederationФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова» Минздрава РоссииРоссияFirst Pavlov St. Petersburg State Medical UniversityRussian Federation2019111220191243542Copyright © Малишевская Т.Н., Губин Д.Г., Немцова И.В., Власова А.С., Филиппова Ю.Е., Фарикова Э.Э., Богданова Д.С., 20192019Малишевская Т.Н., Губин Д.Г., Немцова И.В., Власова А.С., Филиппова Ю.Е., Фарикова Э.Э., Богданова Д.С.Malishevskaya T.N., Gubin D.G., Nemcova I.V., Vlasova A.S., Filippova J.E., Farikova E.E., Bogdanova D.S.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/335

Цель — проанализировать суточную динамику и параметры циркадианного ритма внутриглазного давления (ЦР ВГД) у пациентов с первичной открытоугольной глаукомой (ПОУГ) (со стабильной и прогрессирующей формами), а также установить хронобиологические закономерности прогрессирования глаукомы в зависимости от характера перестройки суточной динамики ЦР ВГД и температуры тела.

Материал и методы

Материал и методы. В исследование включено 75 пациентов с ПОУГ, из них у 35 пациентов глаукома носила стабильный характер (С-ПОУГ) (n = 35), а у 40 — глаукома быстро прогрессировала (П-ПОУГ) (n = 40). Группа контроля включала пациентов без признаков ПОУГ (n = 80). В качестве критерия прогрессирования ПОУГ использовали индекс потери ганглиозных клеток сетчатки (ГКС) по данным оптической когерентной томографии (ОКТ). Самоизмерение ВГД осуществлялось в течение 72 ч в 7 контрольных точках (3, 8, 11, 14, 17, 20, 23 ч) с помощью портативного тонометра для индивидуального использования Icare ONE.

Результаты

Результаты. Суточная динамика ВГД имела гетерогенный характер: у пациентов с С-ПОУГ пиковые значения приходились преимущественно на утренние часы, в то время как в ночное время определялись минимальные значения этого параметра, а у пациентов с П-ПОУГ пиковые значения ВГД зафиксированы в ночные часы. В двух группах ПОУГ выявлен рост доли нерегулярных колебаний, что отражает снижение процентного вклада ЦР в ЦР ВГД. При этом на фоне ПОУГ происходило изменение фазовых соотношений между ЦР ВГД и ЦР температуры тела. Для проявлений фазовых нарушений ЦР ВГД определено пороговое значение индекса глобальных потерь ГКС по данным ОКТ, которое составило 10–15 %.

Заключение

Заключение. Выявлены различия суточной динамики ВГД у пациентов с С-ПОУГ и П-ПОУГ. При этом в двух группах пациентов определены признаки десинхроноза. Индекс глобальных потерь ГКС может быть использован для выявления фазовых нарушений ЦР ВГД.

Purpose

Purpose. To analyze the daily dynamics and the parameters of intraocular pressure circadian rhythm (IOP CR) in patients with primary open-angle glaucoma (POAG) (stable and progressive forms) and determine chronobiological regularities of glaucoma progression depending on the patterns of restructuring the daily dynamics of IOP CR and body temperature.

Material and methods

Material and methods. The study included 75 POAG patients, of which 35 had a stable form (S-POAG) and 40 had a rapidly progressing form (P-POAG). The control group was composed of 80 subjects without POAG. The index of retinal ganglion cell loss measured by optical coherence tomography (OCT) was used as a criterion of POAG progression. IOP was measured by the patients themselves for 72 hours at 7 time points (3 am, 8 am, 11 am, 2 pm, 5 pm, 8 pm, and 11 pm, who used an Icare ONE portable intraocular pressure tonometer for individual use.

Results

Results. IOP daily dynamics was distributed differently in the different groups. In S-POAG, the peak values were mainly reached in the morning hours, while the minimum values were observed at night. In P-POAG, the peak values of IOP were contrariwise recorded at night. In both POAG groups, an increase of irregular fluctuation share was noted, which indicated a decrease of the CR contribution to the IOP CR. Moreover, in POAG, a change in the phase ratio between the IOP CR and CR of body temperature was observed. For IOP CR phase violation manifestations, the threshold value of GCS global loss index was determined at 10–15 % according to OCT data.

Conclusion

Conclusion. IOP daily dynamics were shown to differ in S-POAG and P-POAG patients. In both groups. Signs of desynchronization were detected. The ganglion retinal cell global loss index can be used to determine phase disturbances of IOP CR.

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