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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">glaucoma</journal-id><journal-title-group><journal-title xml:lang="ru">Национальный журнал Глаукома</journal-title><trans-title-group xml:lang="en"><trans-title>National Journal glaucoma</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-4104</issn><issn pub-type="epub">2311-6862</issn><publisher><publisher-name>Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25700/NJG.2019.01.10</article-id><article-id custom-type="elpub" pub-id-type="custom">glaucoma-236</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW OF LITERATURE</subject></subj-group></article-categories><title-group><article-title>Обоснование нейропротекции при глаукоме</article-title><trans-title-group xml:lang="en"><trans-title>Rationale for neuroprotection in glaucoma</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аветисов</surname><given-names>С. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Avetisov</surname><given-names>S. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Академик РАН, доктор медицинских наук, профессор, научный руководитель.</p></bio><bio xml:lang="en"><p>Academician of RAN, Scientific Director.</p><p>11A Rossolimo st., Moscow, 119021</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Еричев</surname><given-names>В. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Erichev</surname><given-names>V. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Еричев Валерий Петрович - lоктор медицинских наук, профессор, руководитель отдела глаукомы.</p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>Med.Sc.D., Professor, Head of Glaucoma Department.</p><p>11A Rossolimo st., Moscow, 119021</p></bio><email xlink:type="simple">erichev@reic.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яременко</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Yaremenko</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аспирант кафедры глазных болезней.</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Postgraduate student.</p><p>8 Trubetskaya st., Moscow, 119991</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ НИИ глазных болезней</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Research Institute of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>14</day><month>05</month><year>2019</year></pub-date><volume>18</volume><issue>1</issue><fpage>85</fpage><lpage>94</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Аветисов С.Э., Еричев В.П., Яременко Т.В., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Аветисов С.Э., Еричев В.П., Яременко Т.В.</copyright-holder><copyright-holder xml:lang="en">Avetisov S.E., Erichev V.P., Yaremenko T.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.glaucomajournal.ru/jour/article/view/236">https://www.glaucomajournal.ru/jour/article/view/236</self-uri><abstract><p>Глаукома — это хроническая прогрессирующая оптическая нейропатия, характеризующаяся изменениями головки зрительного нерва (экскавация) и потерей ганглиозных клеток сетчатки (ГКС) и вследствие этого дефектами полей зрения. Известно, что у некоторых пациентов с глаукомой гибель ГКС продолжается несмотря на нормальные показатели внутриглазного давления (ВГД). Нейропротекция является одним из наиболее перспективных направлений лечения глаукомы. Направлена на предотвращение гибели ганглиозных клеток сетчатки при нормотензивной глаукоме. В зависимости от характера повреждающих факторов и механизмов противодействия им нейропротекция бывает прямая и непрямая, или опосредованная. К непрямой нейропротекции относят снижение ВГД и улучшение гемодинамики. При этом нейропротекторы прямого действия подразделяются на первичные и вторичные. Препараты прямого нейропротекторного действия, такие как антагонисты NMDA-рецепторов, блокаторы кальциевых каналов, обладают защитными свойствами для сетчатки, а именно защищают нейроны сетчатки и волокна зрительного нерва, блокируя основные факторы повреждения клеток, являющиеся следствием развития ишемии и связанные с ней, увеличением концентрации продуктов перекис-ного окисления липидов, свободных радикалов, ионов кальция. Вторичные нейропротекторы направлены на более отсроченные механизмы гибели нейронов. К этой группе относятся такие препараты, как: экстракт гинк-го билоба, антиоксиданты, антиглаукомные препараты с нейротрофическими свойствами (бримонидин, бетак-солол, ингибиторы карбоангидразы, аналоги проста-гландинов), пептидные биорегуляторы. Снижение ВГД по-прежнему является основным средством лечения глаукомы. Вопрос об альтернативных методах, снижающих ВГД и направленных на предотвращение дальнейшего прогрессирования, остается важным. Большие надежды возлагаются на нейропротекцию, которая демонстрирует результативность в предотвращении гибели ГКС, независимо от ВГД. В данной статье представлен широкий выбор препаратов, обладающих нейропротекторным действием и применяемых при глаукоме в комплексе с целевым лечением.</p></abstract><trans-abstract xml:lang="en"><p>Glaucoma is a chronic progressive optic neuropathy, characterized by changes in the optic nerve head (cup) and ganglion cell complex (GCC) loss that lead to field of vision defects. In some patients GCC loss progresses despite intraocular pressure (IOP) level normalization. Today neuroprotection is one of the most promising trends in glaucoma treatment. It is directed at GCC loss prevention in patients with normal-tension glaucoma. Neuroprotection can be direct or indirect, depending on the nature of damaging factors and counteraction mechanisms. Indirect neuroprotection includes IOP level decrease and hemodynamics improvement. Direct neuroprotection can be primary and secondary. Such pharmaceutical groups as NMDA-receptor antagonists and calcium-channel blockers have a direct neuroprotective action. They protect retinal neurons and optic nerve head fibers by blocking the main ischemic cell damage factors and moderate ischemia-associated increase of lipid peroxidation products, free radicals and calcium ions concentration. Secondary neuroprotection drugs influence the delayed neuronal death mechanisms. They include Ginkgo biloba, antioxidants, neurotrophic drugs (Brimonodone, Betaxolol, carbonic anhydrase inhibitors, prostaglandin analogues) and peptide bioregulators. IOP level decrease still remains the main means of glaucoma treatment. One of the questions of considerable substance in IOP lowering achievement is the elaboration of alternative methods aimed at further progression prevention. Based on the latest research, neuroprotective medicine shows promise in GCC loss prevention despite the actual IOP level. This article presents information on a wide range of neuroprotective drugs used in complex glaucoma treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>глаукома</kwd><kwd>нейропротекция</kwd><kwd>ганглиозные клетки сетчатки</kwd><kwd>внутриглазное давление</kwd></kwd-group><kwd-group xml:lang="en"><kwd>glaucoma</kwd><kwd>neuroprotection</kwd><kwd>ganglion cell complex</kwd><kwd>intraocular treatment</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Quigley H.A., Broman A.T. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006; 90(3): 262-267.</mixed-citation><mixed-citation xml:lang="en">Quigley H.A., Broman A.T. The number of people with glaucoma worldwide in 2010 and 2020. 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