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Some Aspects of Vascular Theory of Development and Progression of Primary Open-Angle Glaucoma (Literature Review). Part 1

The article presents a review of studies on various aspects of vascular theory of primary open-angle glaucoma (POAG) development and progression. The data of foreign and domestic scientists on the influence of hemodynamic disturbances in the glaucoma pathogenesis, including various levels: Central, regional and microcirculatory. Violations of the universal mechanism of vascular tone regulation, namely endothelial dysfunction are described. Vascular endothelium is a barrier between vascular wall and blood plasma. When the endothelium is damaged, its antithrombotic properties are transformed into a powerful prothrombotic potential. This leads to an imbalance between vasoconstrictors (endothelin) and vasodilators (nitric oxide). In addition, the release of biologically active substances with local neurotoxic effects. The authors noted an increase in the concentration of endothelin-1, studied its interaction with nitrogen oxide and considered its role in the occurrence of ischemia and the impact on the death of retinal ganglion cells. Scientists have noticed an increase in the level of Willebrand factor and increased platelet aggregation in patients with progressive glaucoma. As a possible cause of hemodynamic disturbances and glaucoma progression, the authors consider changes in blood rheological properties. In addition, the state of the three closely interacting components: the wall of blood vessels (primarily endothelium and subendothelial structures); cellular elements of blood (primarily platelets) and plasma proteolytic systems ensure the normal functioning of the hemostatic system. Changes in of these components state may affect the hemostatic system. Therefore, further study of various directions of vascular theory will help in understanding the etiopathogenesis of glaucoma.