Ophthalmic risk factors for primary open angle glaucoma

Abstract

Primary open angle glaucoma (POAG) is a chronic progressive optic neuropathy, characterized by morphological changes in the optic nerve head and retinal nerve fiber layer. This review analyzes the development of the risk factors for POAG over several decades. The role of systemic diseases as a risk factor has been proven, and ophthalmological factors contributing to the progression of glaucoma are currently being actively studied. The most studied of these is ocular hypertension. A number of studies have shown an effect of both the average increase in the level of intraocular pressure (IOP) and its peak rises during the day on the progression of glaucomatous optic neuropathy (GON). Pseudoexfoliation syndrome and pigment dispersion syndrome, which are characterized by changes in the structures of the eye that increase the sensitivity of the nervous tissue to IOP level differences, can lead to increased IOP levels. An increase in the axial length of the eye associated with myopia is also considered to be a risk factor for the POAG development. In myopia, especially when high severity, there is a stretching of the fibrous tunic of the eye and changes in the structures of the fundus. These changes may be mistakenly diagnosed as glaucomatous, and may also contribute to the GON development. This review provides a summary of current data on the ophthalmic risk factors for the POAG development, which will improve the diagnosis of this disease.  Keywords: primary open angle glaucoma, risk factor, ocular hypertension, pseudoexfoliation syndrome, pigment dispersion syndrome, myopia, myopic refraction.  For citation: Erichev V.P., Onishchenko A.L., Kuroyedov A.V. et al. Ophthalmic risk factors for primary open angle glaucoma. Russian Journal of Clinical Ophthalmology. 2019;19(2):81–86.  1Valery P. Erichev — MD, PhD, Professor, Head of Glaucoma Department, ORCHID iD 0000-0001-6842-7164; 2Aleksandr L. Onishchenko — MD, PhD, Professor, Deputy Director for Scientific Work, ORCHID iD 0000-0002-1549-5742; 3,4Aleksandr V. Kuroyedov — MD, PhD, Professor, Head of Ophthalmological Department, ORCHID iD 0000-0001-9606-0566; 1Sergey Yu. Petrov — MD, PhD, Senior Researcher of Glaucoma Department, ORCHID iD 0000-0001-6922-0464; 5Andrey Yu. Brezhnev — MD, PhD, Associate Professor of Ophthalmological Department, ORCHID iD 0000-0002-5597-983X; 1Alexey A. Antonov — MD, PhD, Senior Researcher of Glaucoma Department, ORCHID iD 0000-0002-5171-8261; 1Aleksandr A. Vitkov — resident physician, ORCHID iD 0000-0001-7735-9650; 6Yuliya K. Murakhovskaya — student, ORCHID iD 0000-0002-1251-6405. 1Scientific Research Institute of Eye Diseases. 11A, Rossolimo str., Moscow, 119021, Russian Federation. 2Novokuznetsk State Institute of Continuing Medical Education — branch of Russian Medical Academy of Continuing Professional Education. 5, Stroiteley prospect, Novokuznetsk, Kemerovo region, 654005, Russian Federation. 3 Pirogov Russian National Research Medical University. 1, Ostrovityanova str., Moscow, 117997, Russian Federation. 4Central Military Clinical Hospital named after P.V. Mandryka. 8A, B. Olenya str., Moscow, 107014, Russian Federation.  5Kursk State Medical University. 3, Karl Marx str., Kursk, 305041, Russian Federation.  6Sechenov University. 8/2, Trubetskaya str., Moscow, 119991, Russian Federation.  Contact information: Aleksandr L. Onishchenkо,  e-mail: [email protected]. Financial Disclosure: no author has a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 13.12.2018.