Современные методы визуализации угла передней камеры глаза в диагностике и лечении глаукомы

Abstract

Purpose. To analyze the literature reflecting the main modern methods of visualizing the angle of the anterior chamber of the eye, which are used in patients with glaucoma. Material and methods. To perform the review, a search was carried out for literature sources on the Pubmed, Scopus and Elibrary reference databases for the period up to 2022 inclusive using the following keywords: anterior camera angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy and the same phrases in Russian. Results. The variety of clinical and morphological forms of glaucoma, the wide prevalence, frequency of occurrence and steady growth of this disease require timely diagnostics, as well as dynamic monitoring of the results of conservative and surgical treatment in patients with glaucoma. Despite the importance of such a diagnostic method as gonioscopy, ophtalmologists still do not use it sufficiently, the frequency of its application during the first visit to the doctor for glaucoma varies from 17.96 to 45.9%. There are also additional instrumental methods of examination of patients with glaucoma that allow an objective assessment of the structures of the eye anterior segment: automated gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy. These methods can be used both for the primary diagnosis of glaucoma and its dynamic observation, as well as for choosing surgical treatment tactics and monitoring its results thanks to high-precision visualisation and image documentation. Each of them has its own characteristics, advantages and disadvantages, depending on the specifics of the disease and the presence of concomitant ocular pathology, which are described in this article. Conclusion. Taking into account the variety of clinical forms of glaucoma and the insufficient equipment of medical institutions, especially primary care, it can be concluded that it is necessary to improve diagnostic algorithms. Methods such as electronic gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy will make the diagnostic process more accurate and informative, help to correctly diagnose and determine treatment tactics for both primary care physicians and surgeons. The possibility of documenting the results obtained and creating a system for their analysis can contribute to the founding of a generalized database, which will greatly simplify and accelerate the process of providing care to patients with glaucoma. Key words: glaucoma, anterior chamber angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy