glaucomaНациональный журнал ГлаукомаNational Journal glaucoma2078-41042311-6862Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”10.25700/NJG.2018.03.10glaucoma-224Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEW OF LITERATUREТеоретическое обоснование нейропротекторной терапии при глаукоме как инволюционно зависимой патологииTheoretical substantiation of neuroprotective therapy in glaucoma as an involution-dependent pathologyЕричевВ. П.ErichevV. P.

д.м.н., профессор, руководитель отдела глаукомы.

119021, Российская Федерация, Москва, ул. Россолимо, 11А.

Med.Sc.D., Professor, Head of Glaucoma Department.

11A Rossolimo st., Moscow, Russian Federation, 119021.

erichev@reic.ruПанюшкинаЛ. А.PanyushkinaL. A.

к.м.н., младший научный сотрудник отдела глаукомы.

119021, Российская Федерация, Москва, ул. Россолимо, 11А.

Ph.D., Junior Research Associate of Glaucoma Departmentt.

11A Rossolimo st., Moscow, Russian Federation, 119021.

ФГБНУ «НИИ глазных болезней».РоссияScientific Research Institute of Eye Diseases.Russian Federation2018301220181738696Copyright © Еричев В.П., Панюшкина Л.А., 20182018Еричев В.П., Панюшкина Л.А.Erichev V.P., Panyushkina L.A.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/224

Несмотря на эффективную гипотензивную терапию, глаукомная оптическая нейропатия нередко прогрессирует. Возможный патогенетический механизм этой прогрессии — нейродегенерация, объединяющая многие инволюционные заболевания, такие как болезнь Альцгеймера, болезнь Паркинсона и другие. Несмотря на разную этиологию и клиническую картину, всех их объединяет несколько общих признаков, характерных для инволюционных заболеваний: увеличение заболеваемости с возрастом, практически бессимптомное начало и прогрессирующее ухудшение функций, генетическая предрасположенность. Гибель нейронов при всех нейродегенеративных заболеваниях (в том числе и глаукоме) осуществляется по механизму апоптоза, в основе которого лежат следующие патологические процессы: депривация нейротрофических факторов, повышение концентрации возбуждающих аминокислот, окислительный стресс и нейровоспаление. В данном обзоре представлены современные данные об аксональной и транссинаптической нейродегенерации, об оксидативном стрессе и глутаматной эксайтоксичности при глаукоме как ведущих звеньях в распространении патологического процесса и основных мишенях для нейропротекторной терапии.

Glaucomatous optic neuropathy in some cases is known to progress despite effective hypotensive therapy. It might be explained by an underlying pathogenic mechanism of neurodegeneration that unites multiple involution-related diseases, such as Alzheimer’s, Parkinson’s and others. Despite differing etiology and clinical picture, they are all united by several common features characteristic of involution-related diseases: age-related morbidity increase, general lack of symptoms at the onset, progressive function deterioration and genetic predisposition. Neuron death in all degenerative diseases including glaucoma follows a common apoptosis mechanism, characterized by the following underlying mechanisms: neurotrophic factor deprivation, excitatory amino acids level increase, oxidative stress and neuroinflammation. This review presents current data on axonal and transsynaptic neurodegeneration, oxidative stress and glutamate exitotoxicity as leading components of the pathological glaucoma process and main targets of neuroprotective therapy.

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