The role of markers of endothelial dysfunction in the early diagnosis of primary open-angle glaucoma

Relevance. Primary open-angle glaucoma (POAG) is a multifactorial neurodegenerative disease characterized by accelerated optic neuropathy, which remains one of the main causes of visual impairment. Objective. To study the main parameters of retinal microcirculation using OCT-A, Doppler ultrasound and biochemical disorders of the vascular endothelium in patients with POAG at various stages of its development and to determine the diagnostic significance in the early diagnosis of this pathology. Material and methods. The study involved 94 POAG patients aged 65 to 80 years. Results and conclusion. OCT-A data indicate early involvement of the lower part of the optic nerve head and peripapillary region of the retina in the pathological process at the initial stage of POAG. The data obtained show that a decrease in the density of blood flow and vessels in the optic nerve head and peripapillary region is determined earlier than functional and structural losses determined by OCT and CP methods. These data provide an opportunity to use OCT with angiography function in early diagnostics of POAG. Endothelial dysfunction in POAG is caused by low levels of von Willebrand factor, VEGF and Endothelin-1, which are one of the reasons for the activation of vasoconstriction mechanisms and weakening of vasodilation of vascular tone. Keywords: primary open-angle glaucoma, OCT-Angiography, hemodynamics, ultrasound Doppler imaging, von Willebrand factor, VEGF, endothelin-1