Modern aspects of glaucoma pathogenesis local factors for development of primary open-angle glaucoma associated with impairment of secretory functions of the eye membranes

Abstract

The research deals with one of the urgent problems of modern ophthalmology: revealing the mechanisms underlying induction of primary open-angle and pseudoexfoliative glaucoma. Till nowadays the problem remains rather actual, as the issue is open to discussion: what are the regional mechanisms underlying the disorders in functions of the trabecular apparatus of the anterior chamber angle of an eye and in the increase of intraocular pressure at the mentioned disease. In line with the modern views, processes underlying the increased intraocular pressure originate in the eye structures as such: in connective-tissue, epithelial and endothelial cells of the ciliary body, cornea, retina, lens, trabecular apparatus of the anterior chamber angle of an eye. These cells possess selective secretory activity in the aspect of producing a number of biologically active substances exerting direct and/or indirect action to the processes regulating intraocular pressure. Available literary data of the last 30 years - which discuss mediatory functions realized by cells of fibroblastic, epithelial and endothelial line in a ciliary body, cornea, retina, lens, a trabecular network - formed a basis for carrying out the research directed to clarify the role of in situ produced fibronectin, IGF-1, PgE2 and cortisol at primary open-angle glaucoma. High indices of fibronectin and IGF-1 found in aqueous humour of patients with primary open-angle glaucoma testify in favor of hypersecretion of mentioned cytokines by cells of the trabecular meshwork. The presence of fibronectin and insulin-like growth factor-1 high concentrations at the primary open-angle glaucoma, and also at pseudoexfoliative glaucoma, testifies to violation of drainage function of trabecular meshwork of the anterior chamber angle of an eye; this latter, to a certain extent, preconditions the high levels of intraocular pressure.