helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2021-14-2-96-102helmholtzeyeinstitute-667Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSВлияние комбинации местных ингибиторов карбоангидразы и бета-адреноблокаторов на внутриглазное давление, зрительные функции и гемодинамику глаза у пациентов с первичной открытоугольной глаукомойImpact of combination of local carbonic anhydrase inhibitors and beta-blockers on intraocular pressure, visual functions and eye hemodynamics in primary open-angle glaucomahttps://orcid.org/0000-0003-3679-8619МалишевскаяТ. Н.MalishevskayaT. N.

Татьяна Николаевна Малишевская — д-р мед. наук, заведующая отделением аналитической работы

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

Tatiana N. Malishevskaya— Dr. of Med. Sci., head of the department of analytics

https://orcid.org/0000-0002-9185-6407КиселеваТ. Н.KiselevaT. N.

Татьяна Николаевна Киселева— д-р мед. наук, профессор, начальник отдела ультразвуковых исследований

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

Tatiana N. Kiseleva — Dr. of Med. Sci., professor, head of ultrasound diagnostic department

https://orcid.org/0000-0002-6835-3393ВласоваА. С.VlasovaA. S.

Анастасия Сергеевна Власова — ассистент кафедры офтальмологии

ул. Прокопия Артамонова, д. 5/11, Тюмень, 625051

Anastasia S. Vlasova— assistant professor, chair of ophthalmology and optometry

https://orcid.org/0000-0002-8099-592XЕлисееваЕ. К.EliseevaE. K.

Елена Константиновна Елисеева— канд. мед. наук, научный сотрудник отдела ультразвуковых исследований

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

Elena K. Eliseeva— Cand. of Med. Sci., researcher of ultrasound diagnostic department

eliseevaek@ya.ruФГБУ «НМИЦ ГБ им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian FederationАНЧОО дополнительного профессионального образования «Западно-Сибирский институт последипломного медицинского образования»РоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation20212006202114296102Copyright © Малишевская Т.Н., Киселева Т.Н., Власова А.С., Елисеева Е.К., 20212021Малишевская Т.Н., Киселева Т.Н., Власова А.С., Елисеева Е.К.Malishevskaya T.N., Kiseleva T.N., Vlasova A.S., Eliseeva E.K.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/667

Оптимизация лекарственной терапии пациентов с первичной открытоугольной глаукомой (ПОУГ) является актуальной проблемой офтальмологии последних десятилетий. В обзоре рассмотрен вопрос о выборе местной гипотензивной терапии и эффективности применения фиксированной комбинации (ФК) дорзоламид/тимолол при ПОУГ. Поскольку снижение перфузионного давления глаза и нарушение регуляции локальной гемодинамики влияют на развитие и прогрессирование глаукоматозной оптической нейропатии, при назначении антиглаукоматозных препаратов или ФК гипотензивных средств рассматривают их влияние не только на внутриглазное давление (ВГД) и зрительные функции, но и на глазной кровоток. Результаты большинства исследований показывают, что гипотензивные и гемодинамические эффекты ФК дорзоламид/тимолол способствуют сохранению полей зрения у пациентов с ПОУГ, оказывая влияние на значимые факторы риска прогрессирования ПОУГ, такие как повыше-ное ВГД и дефицит кровотока в системе ретинальных и хориоидальных сосудов. Улучшение гемодинамических показателей на фоне местного гипотензивного лечения может рассматриваться как основа стабилизации зрительных функций, особенно при длительном хроническом течении заболевания.

Drug treatment optimization in primary open-angle glaucoma (POAG) is a topical issue of ophthalmology in recent decades. The review focuses on the choice of local hypotensive therapy and the effectiveness of a fixed combination (FC) of dorzolamide / timolol in glaucoma treatment. Since decreased perfusion eye pressure and disturbed regulation of local hemodynamics affect the development and progression of glaucomatous optical neuropathy, the use of anti-glaucomatous drugs or other hypotensive agents requires taking account of their effect on intraocular pressure (IOP), visual functions, and ocular blood flow. Most studies show that the hypotensive and hemodynamic effects of dorzolamide/timolol FC contribute to the preservation of visual fields in POAG patients by reducing significant risk factors for POAG progression, such as increased IOP and blood flow deficiency in the retinal and choroidal vessels. Improved hemodynamic parametersdue to local hypotensive treatment can be considered as basis for visual function stabilization, especially in long-term chronic courses of the disease.

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