glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”glaucoma-193Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEW OF LITERATUREРЕТИНОПРОТЕКЦИЯ КАК ТЕРАПЕВТИЧЕСКАЯ СТРАТЕГИЯ ГЛАУКОМЫ: ОБЗОР ИСТОРИЧЕСКИХ И СОВРЕМЕННЫХ МИРОВЫХ ТЕНДЕНЦИЙA REVIEW OF THE HISTORICAL CONTEXT AND EMERGING TRENDS IN RELATION TO RETINOPROTECTION AS A THERAPEUTIC STRATEGY FOR GLAUCOMAЛоскутовИ. А.LoskutovI. A.

Лоскутов Игорь Анатольевич, доктор медицинских наук, заведующий офтальмологическим отделением

125367, Москва, Волоколамское шоссе, д. 84

 

Med.Sc.D., Head of the Ophthalmology Department  

84 Volokolamskoye shosse, Moscow, 125367

 

loskoutigor@mail.ruСаверскаяЕ. Н.SaverskayaE. N.

Доктор медицинских наук, профессор кафедры фармации

125080, Москва, Волоколамское шоссе, д. 11

 

Med.Sc.D., Professor of the Pharmacy Department  

11 Volokolamskoye shosse, Moscow, 125080

ЛоскутоваЕ. И.LoskutovaE. I.

Медицинский директор 

Ирландия, Дублин 7

 

M.D., Medical director

Dublin, 2 Aungier St

Научный клинический центр ОАО «Российские железные дороги»РоссияScientific Clinical Centre of JSC «Russian Railways»Russian FederationИнститут медико-социальных технологий ФГБОУ ВО «Московский государственный университет пищевых производств»РоссияInstitute of Medical and Social Technologies, Moscow State University of Food ProductionRussian FederationVisuHealth, Центр исследования зрения Ирландии, Институт здоровья и экологической устойчивости, технологический институт ДублинаИрландияVisuHealth, Ireland Centre for Eye Research, Environmental Sustainability & Health Institute, Dublin Institute of TechnologyIreland2017050420181648697Copyright © Лоскутов И.А., Саверская Е.Н., Лоскутова Е.И., 20182018Лоскутов И.А., Саверская Е.Н., Лоскутова Е.И.Loskutov I.A., Saverskaya E.N., Loskutova E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.glaucomajournal.ru/jour/article/view/193

В обзоре рассматриваются исторические аспекты нейропротекции как терапевтической парадигмы глаукомы и ганглиозные клетки сетчатки (ГКС) в качестве основной мишени действия нейропротекторов. Контроль внутриглазного давления (ВГД) способствует замедлению гибели ГКС, что само по себе является нейропротекцией. Современные исследования имеют доказательства структурно-функционального ремоделирования всех слоев сетчатки при глаукоме, включая фоторецепторы, пигментный эпителий, биполярные и горизонтальные клетки, астроциты и клетки Мюллера, а также сосудистое русло. В зарубежной литературе обсуждается несколько подходов к лечению глаукомы с точки зрения улучшения функционального состояния ГКС — нейропротекция (≪neuroenhancement≫, ≪нейроулучшение≫) и нейрорегенерация. В связи с имеющимися новыми данными обсуждается необходимость введения понятия ретинопротекции как комплекса терапевтических мероприятий, направленных на предупреждение и восстановление структурно-функциональных повреждений сетчатки и зрительного нерва при глаукоме. Разнообразие потенциальных анатомических целей подразумевает использование лекарственных препаратов различных фармакологических групп. Одной из проблем лекарственной терапии при глаукоме является сложность доставки препарата к сетчатке. В статье приводятся преимущества и ограничения различных путей введения препаратов с целью ретинопротекции

This review focuses on historical aspects of neuroprotection as a therapeutic approach to glaucoma, with the retinal ganglion cell (RGC) layer serving as the main therapeutic target. Adequate control of intraocular pressure (IOP) helps to slow down RGC loss, which is, in itself, neuroprotective. There is now evidence that glaucoma mediated remodelling occurs throughout the cellular and tissue layers of the retina, including photoreceptors, pigment epithelium, bipolar, horizontal and Muller cells, astrocytes and retinal vasculature. Neuroprotection, neuroehancement and neuroregeneration are some of the approaches discussed in the literature. In view of the recent tendencies, we explore the potential of one of these approaches — retinoprotection, which defines a complex of therapeutical measures aimed at preventing structural and functional damage to the retina and optic nerve in glaucoma patients. This is particularly important given that glaucoma is a multifactorial disease and may require a complex approach to treatment.

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The authors declare that there are no conflicts of interest present.