Hypotensive glaucoma therapy and neuroprotection

Журавлева, А. Н.; Mv, Zueva

doi:10.21516/2072-0076-2020-13-2-78-82

Cited by 5 publications

(2 citation statements)

References 51 publications

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“…Данный вопрос представляется нам заслуживающим отдельного внимания в отношении разграничения возможных причин развития ГОН на основе, в частности, нейроваскулярных и нейродегенеративных нарушений. Современные научные достижения свидетельствуют также, что к таким ключевым факторам, по-видимому, следует относить генетические факторы риска развития глаукомы, свойства соединительной ткани глаза и организма в целом, а также сложный паттерн ранних изменений в сетчатке и других структурах зрительной системы, возникающих до появления клинических признаков [25].…”

Section: Optimization Of Medicinal Treatment Of Patients With Glaucomaunclassified

“…Между тем ожидание перехода ГОН в развитую и далеко зашедшую стадию, при которых может быть назначена нейропротекторная терапия, необоснованно. Эффект будет тем выше, чем в более раннюю стадию проведена нейропротекция [25].…”

Section: Optimization Of Medicinal Treatment Of Patients With Glaucomaunclassified

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Optimization of Medicinal Treatment of Patients with Glaucoma in Combination with Concurrent System Pathology. Part 1: Cardiovascular Pathology

Журавлева

Шустов

2020

Oftalʹmologiâ

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This paper presents clinical and pharmacological drug interactions for the treatment of patients with glaucoma combined with concurrent cardiovascular pathology, risks of side effects, and adverse drug reactions. The article discusses the multifactor nature of glaucoma, age factors, and the direction of local and systemic pathogenetic treatment, principles of the personified approach, and its feasibility. It is shown that an essential element of this approach can be a system of questionnaires for glaucoma patients with chronic diseases, the principal place in which is occupied by a questionnaire filled out by the patient himself. Digital processing of individual data and assessments provided by patients allows us to implement the tasks of a personalized approach to the treatment. Analysis of the pharmacological effects of the available and used arsenal of medicinal products allows you to generalize the array of data obtained, to form model algorithms for deciding by an ophthalmologist on the choice of medications. In scheme optimizing of the prescribed medications, it is important to cross-inform between specialists of different profiles (ophthalmologists, therapists, neurologists, cardiologists, endocrinologists, rheumatologists, etc.), create an algorithm for entering the medications of choice and their rational combinations, which reduces the risk of polypragmasia. Possible causes of progression of glaucoma optic neuropathy (GON) against the background of age-related systemic diseases (using the example of the cardiovascular system’s pathology) are considered. Ways of influencing the pathogenetic links of the glaucomatous process are proposed from the standpoint of an optimal combination of medications. Analysis of literature on the problem of structural and functional disorders in GON’s development shows that it is promising to expand our understanding of the fundamental processes underlying these changes, search for clinically significant combinations of contemporary markers of changes in structure and function, and, accordingly, treatment approaches. The possibilities of neuroprotection of glaucoma optical neuropathy, as well as modern methods of electrophysiological research in the monitoring assessment of its effectiveness and the differential diagnosis, approaches to enhance the effectiveness of medications treatment with combined medications are analyzed in the article.

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Section: Optimization Of Medicinal Treatment Of Patients With Glaucomaunclassified

Optimization of Medicinal Treatment of Patients with Glaucoma in Combination with Concurrent System Pathology. Part 1: Cardiovascular Pathology

Журавлева

Шустов

2020

Oftalʹmologiâ

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Fractal Phototherapy in Maximizing Retina and Brain Plasticity

Zueva,

Neroeva,

Zhuravleva

et al. 2024

Advances in Neurobiology

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Structural and functional correlations in the pre-perimetric and the initial stages of glaucomatous optic neuropathy

Кириллова

Журавлева

et al. 2021

Rossijskij oftalʹmologičeskij žurnal

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Purpose:to study morphological and functional relationships in the early and preclinical diagnosis of glaucomatous optical neuropathy based on optical coherence tomography (OCT) of the retina and the data of electrophysiological research. Material and methods. Two clinical groups: (I) 35 patients (60 eyes) aged 49–70 (ave. 58.0 ± 5.3 yrs) with suspected glaucoma and (II) 21 patients (30 eyes) aged 46-68 (ave. 61.0 ± 4.8 yrs) with initial primary open-angle glaucoma (POAG), and a comparison group consisting of 36 relativelyhealthy subjects (41 eyes) aged 54–70 (ave. 62.0 ± 4.5 yrs), were subjected to spectral OCT by OСT Spectralis (Heidelberg Engineering, Germany). The thickness of the peripapillary layer of retinal nerve fibers (pRNFL), the minimum rim width (MRW), and the thickness of theretinal layers in the macular region that make up the ganglion cell complex (GCC) were evaluated. Spearman correlation analysis was used to identify correlations between OCT and electroretinography (ERG) data. Results.In patients with suspected glaucoma, changes in the parameters of transient pattern-ERG correlated with RNFL thinning in the macular region, inner plexiform layer (IPL), and ganglion cell layer(GCL) in the parafoveal area. In patients with initial glaucoma, changes in the retinal GCL were detected for the upper, lower, and temporal quadrants, while the nasal and central quadrants remained intact in all three GCC layers (RNFL, GCL, and IPL). In patients with suspected glaucoma, no statistically significant changes in the thickness of the pRNFL as compared with the norm were detected. Yet the MRW differed significantly from the comparison group. The highest number of correlations was found between the parameters of the ERGs and the thickness of the pRNFL. In patients with the initial stage of POAG, there was a significant increase in the thickness of RNFL in the temporal quadrant of the paramacular region. In our opinion, this phenomenon may be associated with the development of reactive gliosis being thereaction of neuroglia in response to changes in vascular and/or dystrophic homeostasis. Conclusion.Specific combinations of changes in the structural parameters of the retina and optic nerve head and the temporal and amplitude indices of the PERG and phototopic negative response have been found, justifying their use as combined markers of early and preclinical diagnosis of POAG.

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Hypotensive glaucoma therapy and neuroprotection

Cited by 5 publications

References 51 publications

Optimization of Medicinal Treatment of Patients with Glaucoma in Combination with Concurrent System Pathology. Part 1: Cardiovascular Pathology

Optimization of Medicinal Treatment of Patients with Glaucoma in Combination with Concurrent System Pathology. Part 1: Cardiovascular Pathology

Fractal Phototherapy in Maximizing Retina and Brain Plasticity

Structural and functional correlations in the pre-perimetric and the initial stages of glaucomatous optic neuropathy

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