helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2023-16-4-147-151helmholtzeyeinstitute-1369Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSПерспективы нейроретинопротекторной терапии глаукомыProspects for neuroretinoprotective therapy of glaucomaАпрелевА. Е.AprelevA. E.

 

ул. Советская, д. 6, Оренбург, 460000, Россия

Alexander E. Aprelev — Dr. of Med. Sci., assistant professor, head of chair of ophthalmology

6, Sovetskaya St., Orenburg, 460000, Russia

СукманюкЕ. О.SukmanyuE. O.

Екатерина Олеговна Сукманюк — ординатор кафедры офтальмологии

ул. Советская, д. 6, Оренбург, 460000, Россия

Ekaterina O. Sukmanyuk — intern of chair of ophthalmology

6, Sovetskaya St., Orenburg, 460000, Russia

katerinas.k@mail.ruФГБОУ ВО «Оренбургский государственный медицинский университет» Минздрава РоссииРоссияOrenburg State Medical UniversityRussian Federation202329122023164147151Copyright © Апрелев А.Е., Сукманюк Е.О., 20232023Апрелев А.Е., Сукманюк Е.О.Aprelev A.E., Sukmanyu E.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1369

Результаты современных исследований патогенеза глаукомы как нейродегенеративного заболевания не оставляют сомнений в необходимости ее нейропротекторной терапии. Доказано, что достижение целевого внутриглазного давления с помощью гипотензивных средств не всегда приводит к стабилизации глаукомного процесса, о чем говорит дальнейшее снижение зрительных функций и гибель ганглионарных клеток сетчатки. В настоящее время исследования сосредоточены на поиске новых препаратов, способных замедлить повреждение нервных волокон зрительного нерва и предотвратить апоптотическую гибель нейронов. В данном обзоре представлены результаты последних экспериментальных и клинических разработок наиболее перспективных нейропротекторных препаратов.

The results of present-day research into the pathogenesis of glaucoma as a neurodegenerative disease, leave no doubt that neuroprotective therapy of the condition is needed. It has been proven that achieving the target intraocular pressure does not always lead to the stabilization of the glaucoma process, as evidenced by a further decrease in visual functions and the death of retinal ganglion cells. Currently, research is focused on finding new drugs that can slow down the damage to the nerve fibers of the optic nerve and prevent apoptotic neuronal death. This literature review presents the results of recent experimental and clinical studies of the most promising neuroprotective drugs.

глаукоманейропротекцияглаукомная оптиконейропатияglaucomaneuroprotectionglaucomatous optic neuropathyReferencesGBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021; 9 (2): 44–160. doi: 10.1016/S2214-109X(20)30489-7GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021; 9 (2): 44–160. doi: 10.1016/S2214-109X(20)30489-7Chan JW, Chan NCY, Sadun A.A. Glaucoma as Neurodegeneration in the Brain. Eye Brain. 2021; 13: 21–8. doi: 10.2147/EB.S293765Chan JW, Chan NCY, Sadun A.A. Glaucoma as Neurodegeneration in the Brain. Eye Brain. 2021; 13: 21–8. doi: 10.2147/EB.S293765Егоров Е.А., Алексеев В.Н., Газизова И.Р. Первичная открытоугольная глаукома: нейродегенерация и нейропротекция. Москва: ГЭОТАР-Медиа; 2019.Егоров Е.А., Алексеев В.Н., Газизова И.Р. Первичная открытоугольная глаукома: нейродегенерация и нейропротекция. Москва: ГЭОТАР-Медиа; 2019.Еgorov Е.А., Alekseev V.N., Gazizova I.R. Primary open-angle glaucoma: neurodegeneration and neuroprotection. Moscow: GEOTAR-Media; 2019 (In Russ.).Еgorov Е.А., Alekseev V.N., Gazizova I.R. Primary open-angle glaucoma: neurodegeneration and neuroprotection. Moscow: GEOTAR-Media; 2019 (In Russ.).Карпилова М.А., Полуянова А.Д. Антиоксидантные нутрицевтики при глаукоме. Вестник офтальмологии. 2020; 136 (4): 317–23.Карпилова М.А., Полуянова А.Д. Антиоксидантные нутрицевтики при глаукоме. Вестник офтальмологии. 2020; 136 (4): 317–23.Karpilova M.A., Poluianova A.D. Antioxidant nutraceuticals for glaucoma. Vestnik oftal’mologii. 2020; 136 (4): 317–23 (In Russ.). doi: 10.17116/oftalma2020136042317Karpilova M.A., Poluianova A.D. Antioxidant nutraceuticals for glaucoma. Vestnik oftal’mologii. 2020; 136 (4): 317–23 (In Russ.). doi: 10.17116/oftalma2020136042317Cvenkel B, Kolko M. Current medical therapy and future trends in the management of glaucoma treatment. Journal of ophthalmologу. 2020; 6138132. doi:10.1155/2020/6138132Cvenkel B, Kolko M. Current medical therapy and future trends in the management of glaucoma treatment. Journal of ophthalmologу. 2020; 6138132. doi:10.1155/2020/6138132Vernazza S, Oddone F, Tirendi S, Bassi A.M. Risk factors for retinal ganglion cell distress in glaucoma and neuroprotective potential intervention. International Journal of Molecular Sciences. 2021; 22 (15): 7994. doi: 10.3390/ijms22157994Vernazza S, Oddone F, Tirendi S, Bassi A.M. Risk factors for retinal ganglion cell distress in glaucoma and neuroprotective potential intervention. International Journal of Molecular Sciences. 2021; 22 (15): 7994. doi: 10.3390/ijms22157994Аветисов С.Э., Еричев В.П., Яременко Т.В. Обоснование нейропротекции при глаукоме. Национальный журнал глаукома. 2019; 18 (1): 85–94.Аветисов С.Э., Еричев В.П., Яременко Т.В. Обоснование нейропротекции при глаукоме. Национальный журнал глаукома. 2019; 18 (1): 85–94.Avetisov S.E., Erichev V.P., Yaremenko T.V. Rationale for neuroprotection in glaucoma. National Journal glaucoma. 2019; 18 (1): 85–94 (In Russ.). doi: 10.25700/NJG.2019.01.10Avetisov S.E., Erichev V.P., Yaremenko T.V. Rationale for neuroprotection in glaucoma. National Journal glaucoma. 2019; 18 (1): 85–94 (In Russ.). doi: 10.25700/NJG.2019.01.10Arfuzir NNN, Agarwal R, Iezhitsa I, et al. Taurine protects against retinal and optic nerve damage induced by endothelin-1 in rats via antioxidant effects. Neural regeneration research. 2018; 13: 2014. doi: 10.4103/1673-5374.239450Arfuzir NNN, Agarwal R, Iezhitsa I, et al. Taurine protects against retinal and optic nerve damage induced by endothelin-1 in rats via antioxidant effects. Neural regeneration research. 2018; 13: 2014. doi: 10.4103/1673-5374.239450Iezhitsa I, Agarwal R. New solutions for old challenges in glaucoma treatment: is taurine an option to consider? Neural regeneration research. 2021; 16 (5): 967–71. doi: 10.4103/1673-5374.297059Iezhitsa I, Agarwal R. New solutions for old challenges in glaucoma treatment: is taurine an option to consider? Neural regeneration research. 2021; 16 (5): 967–71. doi: 10.4103/1673-5374.297059Lambuk L, Iezhitsa I, Agarwal R, et al. Antiapoptotic effect of taurine against NMDAinduced retinal excitotoxicity in rats. Neurotoxicology. 2019; 70: 62–71. doi:10.1016/j.neuro.2018.10.009Lambuk L, Iezhitsa I, Agarwal R, et al. Antiapoptotic effect of taurine against NMDAinduced retinal excitotoxicity in rats. Neurotoxicology. 2019; 70: 62–71. doi:10.1016/j.neuro.2018.10.009Jafri A, Agarwal R, Iezhitsa I, et al. Protective effect of magnesium acetyltaurate and taurine against NMDA-induced retinal damage involves reduced nitrosative stress. Molecular vision. 2018; 24: 495–508. doi:10.1016/j.jtemb.2016.09.005Jafri A, Agarwal R, Iezhitsa I, et al. Protective effect of magnesium acetyltaurate and taurine against NMDA-induced retinal damage involves reduced nitrosative stress. Molecular vision. 2018; 24: 495–508. doi:10.1016/j.jtemb.2016.09.005Adornetto A, Rombolà L, Morrone LA, et al. Natural products: Evidence for neuroprotection to be exploited in glaucoma. Nutrients. 2020; 12 (10): 3158. doi: 10.3390/nu12103158Adornetto A, Rombolà L, Morrone LA, et al. Natural products: Evidence for neuroprotection to be exploited in glaucoma. Nutrients. 2020; 12 (10): 3158. doi: 10.3390/nu12103158Gandolfi S, Marchini G, Caporossi A, et al. Cytidine 5'-Diphosphocholine (Citicoline): Evidence for a neuroprotective role in glaucoma. Nutrients. 2020; 12 (3): 793. doi: 10.3390/nu12030793Gandolfi S, Marchini G, Caporossi A, et al. Cytidine 5'-Diphosphocholine (Citicoline): Evidence for a neuroprotective role in glaucoma. Nutrients. 2020; 12 (3): 793. doi: 10.3390/nu12030793Rossetti L, Iester M, Tranchina L, et al. Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebocontrolled Clinical Trial. Journal of glaucoma. 2020; 29 (7): 513–20. doi: 10.1097/IJG.0000000000001565Rossetti L, Iester M, Tranchina L, et al. Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebocontrolled Clinical Trial. Journal of glaucoma. 2020; 29 (7): 513–20. doi: 10.1097/IJG.0000000000001565Lanza M, Gironi Carnevale UA, Mele L, et al. Morphological and functional evaluation of oral Citicoline therapy in chronic open-angle glaucoma patients: A pilot study with a 2-year follow-up. Frontiers in pharmacology. 2019; 10: 1117. doi: 10.3389/fphar.2019.01117Lanza M, Gironi Carnevale UA, Mele L, et al. Morphological and functional evaluation of oral Citicoline therapy in chronic open-angle glaucoma patients: A pilot study with a 2-year follow-up. Frontiers in pharmacology. 2019; 10: 1117. doi: 10.3389/fphar.2019.01117Parisi V, Oddone F, Roberti G, et al. Enhancement of retinal function and of neural conduction along the visual pathway induced by treatment with Citicoline eye drops in liposomal formulation in open angle glaucoma: A pilot electrofunctional study. Advances in therapy. 2019; 36 (4): 987–96. doi: 10.1007/s12325-019-0897-zParisi V, Oddone F, Roberti G, et al. Enhancement of retinal function and of neural conduction along the visual pathway induced by treatment with Citicoline eye drops in liposomal formulation in open angle glaucoma: A pilot electrofunctional study. Advances in therapy. 2019; 36 (4): 987–96. doi: 10.1007/s12325-019-0897-zMarino PF, Rossi G, Campagna G, Capobianco D, Costagliola C, on behalf of Qualicos Study Group. Effects of Citicoline, Homotaurine, and vitamin E on contrast sensitivity and visual-related quality of life in patients with primary open-angle glaucoma: A preliminary study. Molecules (Basel, Switzerland). 2020; 25 (23): 5614. doi: 10.3390/molecules25235614Marino PF, Rossi G, Campagna G, Capobianco D, Costagliola C, on behalf of Qualicos Study Group. Effects of Citicoline, Homotaurine, and vitamin E on contrast sensitivity and visual-related quality of life in patients with primary open-angle glaucoma: A preliminary study. Molecules (Basel, Switzerland). 2020; 25 (23): 5614. doi: 10.3390/molecules25235614Dammak A, Huete-Toral F, Carpena-Torres C, et al. From oxidative stress to inflammation in the posterior ocular diseases: Diagnosis and treatment. Pharmaceutics. 2021; 13 (9): 1376. doi: 10.3390/pharmaceutics13091376Dammak A, Huete-Toral F, Carpena-Torres C, et al. From oxidative stress to inflammation in the posterior ocular diseases: Diagnosis and treatment. Pharmaceutics. 2021; 13 (9): 1376. doi: 10.3390/pharmaceutics13091376Лоскутов И.А., Корнеева А.В. Роль витаминов группы В в предупреждении прогрессирования глаукомной оптической нейропатии. Национальный журнал глаукома. 2021; 20 (3): 87–101.Лоскутов И.А., Корнеева А.В. Роль витаминов группы В в предупреждении прогрессирования глаукомной оптической нейропатии. Национальный журнал глаукома. 2021; 20 (3): 87–101.Loskoutov I.A., Korneeva A.V. The role of B vitamins in preventing the progression of glaucomatous optic neuropathy. National journal glaucoma. 2021; 20 (3): 87–101 (In Russ.). doi: 10.25700/2078-4104-2021-20-3-87-101Loskoutov I.A., Korneeva A.V. The role of B vitamins in preventing the progression of glaucomatous optic neuropathy. National journal glaucoma. 2021; 20 (3): 87–101 (In Russ.). doi: 10.25700/2078-4104-2021-20-3-87-101Корнеева А.В., Куроедов А.В., Газизова И.Р. и др. Влияние никотинамида на течение глаукомы. Национальный журнал глаукома. 2020; 19 (3): 75–81.Корнеева А.В., Куроедов А.В., Газизова И.Р. и др. Влияние никотинамида на течение глаукомы. Национальный журнал глаукома. 2020; 19 (3): 75–81.Korneeva A.V., Kuroyedov A.V., Gazizova I.R., et al. Influence of nicotinamide on glaucoma patients. National journal glaucoma. 2020; 19 (3): 75–81 (In Russ.). doi: 10.25700/NJG.2020.03.08Korneeva A.V., Kuroyedov A.V., Gazizova I.R., et al. Influence of nicotinamide on glaucoma patients. National journal glaucoma. 2020; 19 (3): 75–81 (In Russ.). doi: 10.25700/NJG.2020.03.08Williams PA, Harder JM, John SWM. Glaucoma as a metabolic optic neuropathy: Making the case for nicotinamide treatment in glaucoma. Journal of glaucoma. 2017; 26 (12): 1161–8. doi: 10.1097/IJG.0000000000000767Williams PA, Harder JM, John SWM. Glaucoma as a metabolic optic neuropathy: Making the case for nicotinamide treatment in glaucoma. Journal of glaucoma. 2017; 26 (12): 1161–8. doi: 10.1097/IJG.0000000000000767Williams PA, Harder JM, Cardozo BH, Foxworth NE, John SWM. Nicotinamide treatment robustly protects from inherited mouse glaucoma. Communicative & integrative biology. 2018; 11 (1): 1356956. doi: 10.1080/19420889.2017.1356956Williams PA, Harder JM, Cardozo BH, Foxworth NE, John SWM. Nicotinamide treatment robustly protects from inherited mouse glaucoma. Communicative & integrative biology. 2018; 11 (1): 1356956. doi: 10.1080/19420889.2017.1356956Hui Flora, Tang J, Williams PA, et al. Improvement in inner retinal function in glaucoma with nicotinamide (vitamin B3) supplementation: A crossover randomized clinical trial. Clinical & experimental ophthalmology. 2020; 48 (7): 903–14. doi: 10.1111/ceo.13818Hui Flora, Tang J, Williams PA, et al. Improvement in inner retinal function in glaucoma with nicotinamide (vitamin B3) supplementation: A crossover randomized clinical trial. Clinical & experimental ophthalmology. 2020; 48 (7): 903–14. doi: 10.1111/ceo.13818Lee D, Shim MS, Kim K Y, et al. Coenzyme Q10 inhibits glutamate excitotoxicity and oxidative stress-mediated mitochondrial alteration in a mouse model of glaucoma. Invest Ophthalmol Vis Sci. 2014; 55 (2): 993–1005. doi: 10.1167/iovs.13-12564Lee D, Shim MS, Kim K Y, et al. Coenzyme Q10 inhibits glutamate excitotoxicity and oxidative stress-mediated mitochondrial alteration in a mouse model of glaucoma. Invest Ophthalmol Vis Sci. 2014; 55 (2): 993–1005. doi: 10.1167/iovs.13-12564Davis BM, Tian K, Pahlitzsch M, et al. Topical Coenzyme Q10 demonstrates mitochondrial-mediated neuroprotection in a rodent model of ocular hypertension. Mitochondrion. 2017; 36: 114–23. doi: 10.1016/j.mito.2017.05.010Davis BM, Tian K, Pahlitzsch M, et al. Topical Coenzyme Q10 demonstrates mitochondrial-mediated neuroprotection in a rodent model of ocular hypertension. Mitochondrion. 2017; 36: 114–23. doi: 10.1016/j.mito.2017.05.010Quaranta L, Riva I, CoQun Study Group, et al. Evaluating the effects of an ophthalmic solution of Coenzyme Q10 and vitamin E in open-angle glaucoma patients: A study protocol. Advances in therapy. 2019; 36 (9): 2506–14. doi: 10.1007/s12325-019-01023-3Quaranta L, Riva I, CoQun Study Group, et al. Evaluating the effects of an ophthalmic solution of Coenzyme Q10 and vitamin E in open-angle glaucoma patients: A study protocol. Advances in therapy. 2019; 36 (9): 2506–14. doi: 10.1007/s12325-019-01023-3Ozates S, Elgin KU, Yilmaz NS, et al. Evaluation of oxidative stress in pseudoexfoliative glaucoma patients treated with and without topical coenzyme Q10 and vitamin E. European journal of ophthalmology. 2019; 29 (2): 196–201. doi: 10.1177/1120672118779486Ozates S, Elgin KU, Yilmaz NS, et al. Evaluation of oxidative stress in pseudoexfoliative glaucoma patients treated with and without topical coenzyme Q10 and vitamin E. European journal of ophthalmology. 2019; 29 (2): 196–201. doi: 10.1177/1120672118779486Егоров Е.А., Егорова Е.А., Еричев В.П., ред. Национальное руководство по глаукоме. Москва: ГЭОТАР-Медиа; 2019.Егоров Е.А., Егорова Е.А., Еричев В.П., ред. Национальное руководство по глаукоме. Москва: ГЭОТАР-Медиа; 2019.Egorov E.A., Egorova E.A., Erichev V.P., eds. National guidelines for glaucoma. Moscow: GEOTAR-Media; 2019 (In Russ.).Egorov E.A., Egorova E.A., Erichev V.P., eds. National guidelines for glaucoma. Moscow: GEOTAR-Media; 2019 (In Russ.).Егоров А.Е., Глазко Н.Г., Мовсисян А.Б. Гипотензивная и нейропротективная терапия глаукомы: реалии и перспективы. Клиническая офтальмология. 2019; 19 (3): 128–35.Егоров А.Е., Глазко Н.Г., Мовсисян А.Б. Гипотензивная и нейропротективная терапия глаукомы: реалии и перспективы. Клиническая офтальмология. 2019; 19 (3): 128–35.Egorov A.E., Glazko N.G., Movsisjan A.B. Hypotensive and neuroprotective therapy of glaucoma: realities and prospects. Clinical ophthalmology. 2019; 19 (3): 128–35 (In Russ.). doi: 10.32364/2311-7729-2019-19-3-128-135Egorov A.E., Glazko N.G., Movsisjan A.B. Hypotensive and neuroprotective therapy of glaucoma: realities and prospects. Clinical ophthalmology. 2019; 19 (3): 128–35 (In Russ.). doi: 10.32364/2311-7729-2019-19-3-128-135Курышева Н.И. Долгосрочное применение латанопроста в лечении глаукомы. Вестник офтальмологии. 2020; 136 (2): 125–32.Курышева Н.И. Долгосрочное применение латанопроста в лечении глаукомы. Вестник офтальмологии. 2020; 136 (2): 125–32.Kurysheva N.I. Long-term use of latanoprost in the treatment of glaucoma. Vestnik Oftal’mologii. 2020; 136 (2): 125–32 (In Russ.). doi: 10.17116/oftalma2020136021125Kurysheva N.I. Long-term use of latanoprost in the treatment of glaucoma. Vestnik Oftal’mologii. 2020; 136 (2): 125–32 (In Russ.). doi: 10.17116/oftalma2020136021125Erb C, Konieczka K. Rho-Kinase-Hemmer als neue lokale Therapieoption beim primären Offenwinkelglaukom. Ophthalmologe. 2021; 118 (5): 449–60 (in German). doi: 10.1007/s00347-020-01303-2Erb C, Konieczka K. Rho-Kinase-Hemmer als neue lokale Therapieoption beim primären Offenwinkelglaukom. Ophthalmologe. 2021; 118 (5): 449–60 (in German). doi: 10.1007/s00347-020-01303-2Asrani S, Robin AL, Serle JB, et al. Netarsudil/Latanoprost fixed-dose combination for elevated intraocular pressure: Three-month data from a randomized phase 3 trial. Am J Ophthalmol. 2019; 207: 248–57. doi: 10.1016/j.ajo.2019.06.016Asrani S, Robin AL, Serle JB, et al. Netarsudil/Latanoprost fixed-dose combination for elevated intraocular pressure: Three-month data from a randomized phase 3 trial. Am J Ophthalmol. 2019; 207: 248–57. doi: 10.1016/j.ajo.2019.06.016Tanna AP, Johnson M. Rho Kinase inhibitors as a novel treatment for glaucoma and ocular hypertension. Ophthalmology. 2018; 125 (11): 1741–56. doi: 10.1016/j.ophtha.2018.04.040Tanna AP, Johnson M. Rho Kinase inhibitors as a novel treatment for glaucoma and ocular hypertension. Ophthalmology. 2018; 125 (11): 1741–56. doi: 10.1016/j.ophtha.2018.04.040Астахов Ю.С., Нечипоренко П.А. Аналоги простагландинов: прошлое, настоящее и будущее. Офтальмологические ведомости. 2017; 10 (1): 40–52.Астахов Ю.С., Нечипоренко П.А. Аналоги простагландинов: прошлое, настоящее и будущее. Офтальмологические ведомости. 2017; 10 (1): 40–52.Astakhov J.S., Nechiporenko P.A. Prostaglandin analogues: past, present and future. Oftalmologicheskie vedomosti. 2017; 10 (1): 40–52 (In Russ.). doi:https://doi.org/10.17816/OV10140-52Astakhov J.S., Nechiporenko P.A. Prostaglandin analogues: past, present and future. Oftalmologicheskie vedomosti. 2017; 10 (1): 40–52 (In Russ.). doi:https://doi.org/10.17816/OV10140-52Doozandeh A, Yazdani S. Neuroprotection in glaucoma. Journal of ophthalmic & vision research. 2016; 11 (2): 209–20. doi: 10.4103/2008-322X.183923Doozandeh A, Yazdani S. Neuroprotection in glaucoma. Journal of ophthalmic & vision research. 2016; 11 (2): 209–20. doi: 10.4103/2008-322X.183923Lee D, Kim KY, Noh YH, et al. Brimonidine blocks glutamate excitotoxicity-induced oxidative stress and preserves mitochondrial transcription factor a in ischemic retinal injury. PLoS One. 2012; 7 (10): 47098. doi: 10.1371/journal.pone.0047098Lee D, Kim KY, Noh YH, et al. Brimonidine blocks glutamate excitotoxicity-induced oxidative stress and preserves mitochondrial transcription factor a in ischemic retinal injury. PLoS One. 2012; 7 (10): 47098. doi: 10.1371/journal.pone.0047098Conti F, Romano GL, Eandi CM, et al. Brimonidine is neuroprotective in animal paradigm of retinal ganglion cell damage. Frontiers in pharmacology. 2021; 12: 705405. doi: 10.3389/fphar.2021.705405Conti F, Romano GL, Eandi CM, et al. Brimonidine is neuroprotective in animal paradigm of retinal ganglion cell damage. Frontiers in pharmacology. 2021; 12: 705405. doi: 10.3389/fphar.2021.705405Nizari S, Guo L, Davis BM, et al. Non-amyloidogenic effects of α2 adrenergic agonists: implications for brimonidine-mediated neuroprotection. Cell death & disease. 2016; 7 (12): 2514. doi: 10.1038/cddis.2016.397Nizari S, Guo L, Davis BM, et al. Non-amyloidogenic effects of α2 adrenergic agonists: implications for brimonidine-mediated neuroprotection. Cell death & disease. 2016; 7 (12): 2514. doi: 10.1038/cddis.2016.397Михайлова Т.Н. Нейропротекторные свойства бримонидина. Офтальмохирургия. 2019; 3: 78–91.Михайлова Т.Н. Нейропротекторные свойства бримонидина. Офтальмохирургия. 2019; 3: 78–91.Mikhailova T.N. Neuroprotective properties of brimonidine. Fyodorov Journal of Ophthalmic Surgery. 2019; 3: 78–91 (In Russ.). doi: https://doi.org/10.25276/0235-4160-2019-3-78-91Mikhailova T.N. Neuroprotective properties of brimonidine. Fyodorov Journal of Ophthalmic Surgery. 2019; 3: 78–91 (In Russ.). doi: https://doi.org/10.25276/0235-4160-2019-3-78-91Krupin T, Liebmann JM, Greenfield DS, et al. A randomized trial of brimonidine versus timolol in preserving visual function: results from the Low-Pressure Glaucoma Treatment Study. Am J Ophthalmol. 2011; 151 (4): 671–81. doi: 10.1016/j.ajo.2010.09.026Krupin T, Liebmann JM, Greenfield DS, et al. A randomized trial of brimonidine versus timolol in preserving visual function: results from the Low-Pressure Glaucoma Treatment Study. Am J Ophthalmol. 2011; 151 (4): 671–81. doi: 10.1016/j.ajo.2010.09.026Evans DW, Hosking SL, Gherghel D, Bartlett JD. Contrast sensitivity improves after brimonidine therapy in primary open angle glaucoma: a case for neuroprotection. Br J Ophthalmol. 2003; 87 (12): 1463–5. doi: 10.1136/bjo.87.12.1463Evans DW, Hosking SL, Gherghel D, Bartlett JD. Contrast sensitivity improves after brimonidine therapy in primary open angle glaucoma: a case for neuroprotection. Br J Ophthalmol. 2003; 87 (12): 1463–5. doi: 10.1136/bjo.87.12.1463Tsai JC, Chang HW. Comparison of the effects of brimonidine 0.2 % and timolol 0.5 % on retinal nerve fiber layer thickness in ocular hypertensive patients: a prospective, unmasked study. Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics. 2005; 21 (6): 475–82. doi: 10.1089/jop.2005.21.475Tsai JC, Chang HW. Comparison of the effects of brimonidine 0.2 % and timolol 0.5 % on retinal nerve fiber layer thickness in ocular hypertensive patients: a prospective, unmasked study. Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics. 2005; 21 (6): 475–82. doi: 10.1089/jop.2005.21.475Захаров В.В., Бакулин И.С. Билобил интенс — нейропротективный препарат растительного происхождения: спектр применения в неврологии. Нервные болезни. 2017; 1: 15–22.Захаров В.В., Бакулин И.С. Билобил интенс — нейропротективный препарат растительного происхождения: спектр применения в неврологии. Нервные болезни. 2017; 1: 15–22.Zakharov V.V., Bakulin I.S. Bilobil intense — a neuroprotective herbal drug: a range of applications in neurology. Nervous diseases. 2017; 1: 15–22 (In Russ.).Zakharov V.V., Bakulin I.S. Bilobil intense — a neuroprotective herbal drug: a range of applications in neurology. Nervous diseases. 2017; 1: 15–22 (In Russ.).Nguyen T, Alzahrani T. Ginkgo Biloba. Treasure Island (FL); StatPearls Publishing: 2021.Nguyen T, Alzahrani T. Ginkgo Biloba. Treasure Island (FL); StatPearls Publishing: 2021.Labkovich M, Jacobs EB, Bhargava S, Pasquale LR, Ritch R. Ginkgo Biloba Extract in ophthalmic and systemic disease, with a focus on normal-tension glaucoma. Asia-Pacific journal of ophthalmology. 2020; 9 (3): 215–25. doi: 10.1097/APO.0000000000000279Labkovich M, Jacobs EB, Bhargava S, Pasquale LR, Ritch R. Ginkgo Biloba Extract in ophthalmic and systemic disease, with a focus on normal-tension glaucoma. Asia-Pacific journal of ophthalmology. 2020; 9 (3): 215–25. doi: 10.1097/APO.0000000000000279Harris A, Gross J, Moore N, et al. The effects of antioxidants on ocular blood flow in patients with glaucoma. Acta ophthalmologica. 2018; 96 (2): 237–e241. doi: 10.1111/aos.13530Harris A, Gross J, Moore N, et al. The effects of antioxidants on ocular blood flow in patients with glaucoma. Acta ophthalmologica. 2018; 96 (2): 237–e241. doi: 10.1111/aos.13530Sabaner MC, Dogan M, Altin SS, et al. Ginkgo Biloba affects microvascular morphology: a prospective optical coherence tomography angiography pilot study. International ophthalmology. 2021; 41 (3): 1053–61. doi: 10.1007/s10792-020-01663-3Sabaner MC, Dogan M, Altin SS, et al. Ginkgo Biloba affects microvascular morphology: a prospective optical coherence tomography angiography pilot study. International ophthalmology. 2021; 41 (3): 1053–61. doi: 10.1007/s10792-020-01663-3Миронова Е.С., Линькова Н.С., Попович И.Г., Козина Л.С., Хавинсон В.Х. Нейропротекторные эффекты пептидов. Успехи геронтологии. 2020; 33 (2): 299–306.Миронова Е.С., Линькова Н.С., Попович И.Г., Козина Л.С., Хавинсон В.Х. Нейропротекторные эффекты пептидов. Успехи геронтологии. 2020; 33 (2): 299–306.Mironova E.S., Linkova N.S., Popovich I.G., Kozina L.S., Khavinson V.Kh. Neuroprotective effects of peptides. Advances in gerontology. 2020; 33 (2): 299–306 (In Russ.).Mironova E.S., Linkova N.S., Popovich I.G., Kozina L.S., Khavinson V.Kh. Neuroprotective effects of peptides. Advances in gerontology. 2020; 33 (2): 299–306 (In Russ.).Страхов В.В., Ярцев А.В., Алексеев В.В. и др. Структурно-функциональные изменения слоев сетчатки при первичной глаукоме и возможные пути ретинопротекции. Вестник офтальмологии. 2019; 135 (2): 70–82.Страхов В.В., Ярцев А.В., Алексеев В.В. и др. Структурно-функциональные изменения слоев сетчатки при первичной глаукоме и возможные пути ретинопротекции. Вестник офтальмологии. 2019; 135 (2): 70–82.Strakhov V.V., Yartsev A.V., Alekseev V.V., et al. Structural and functional changes in the layers of the retina in primary glaucoma and possible ways of retinoprotection. Vestnik ofttal’mologii. 2019; 135 (2): 70–82 (In Russ.).Strakhov V.V., Yartsev A.V., Alekseev V.V., et al. Structural and functional changes in the layers of the retina in primary glaucoma and possible ways of retinoprotection. Vestnik ofttal’mologii. 2019; 135 (2): 70–82 (In Russ.).Дорофеев Д.А., Кирилик Е.В., Климова А.В., Соловьева О.Б. Влияние ретинопротекторной терапии на показатели оптической когерентной томографии с функцией ангиографии (пилотное исследование). Вестник офтальмологии. 2021; 137 (1): 60–7.Дорофеев Д.А., Кирилик Е.В., Климова А.В., Соловьева О.Б. Влияние ретинопротекторной терапии на показатели оптической когерентной томографии с функцией ангиографии (пилотное исследование). Вестник офтальмологии. 2021; 137 (1): 60–7.Dorofeev D.A., Kirilik E.V., Klimova A.V., Solovieva O.B. Effect of retinoprotective therapy on the performance of optical coherence tomography with angiography function (pilot study). Vestnik ofttal’mologii. 2021; 137 (1): 60–7 (In Russ.).Dorofeev D.A., Kirilik E.V., Klimova A.V., Solovieva O.B. Effect of retinoprotective therapy on the performance of optical coherence tomography with angiography function (pilot study). Vestnik ofttal’mologii. 2021; 137 (1): 60–7 (In Russ.).Алексеев В.Н., Мартынова Е.Б., Малеванная О.А., Левко М.А., Нуреддине Ж. Оценка результатов длительного наблюдения за больными первичной глаукомой при комплексном лечении с применением пептидных биорегуляторов. РМЖ. Клиническая офтальмология. 2017; 17 (4): 201–4.Алексеев В.Н., Мартынова Е.Б., Малеванная О.А., Левко М.А., Нуреддине Ж. Оценка результатов длительного наблюдения за больными первичной глаукомой при комплексном лечении с применением пептидных биорегуляторов. РМЖ. Клиническая офтальмология. 2017; 17 (4): 201–4.Alekseev V.N., Martynova E.B., Malevannaya O.A., Levko M.A., Nureddine Zh. Evaluation of the results of long-term follow-up of patients with primary glaucoma in complex treatment using peptide bioregulators. Clinical ophthalmology. 2017; 17 (4): 201–4 (In Russ.).Alekseev V.N., Martynova E.B., Malevannaya O.A., Levko M.A., Nureddine Zh. Evaluation of the results of long-term follow-up of patients with primary glaucoma in complex treatment using peptide bioregulators. Clinical ophthalmology. 2017; 17 (4): 201–4 (In Russ.).Апрелев А.Е., Барбос Ю.А., Муханько И.Ж. и др. Эффективность нейропротекторной терапии у пациентов с глаукомой. Саратовский научно-медицинский журнал. 2018; 14 (4): 828–31.Апрелев А.Е., Барбос Ю.А., Муханько И.Ж. и др. Эффективность нейропротекторной терапии у пациентов с глаукомой. Саратовский научно-медицинский журнал. 2018; 14 (4): 828–31.Aprelev A.E., Barbos Yu.A., Mukhanko I.Zh., et al. Efficiency of neuroprotective therapy in patients with glaucoma. Saratov scientific medical journal. 2018; 14 (4): 828–31 (In Russ.).Aprelev A.E., Barbos Yu.A., Mukhanko I.Zh., et al. Efficiency of neuroprotective therapy in patients with glaucoma. Saratov scientific medical journal. 2018; 14 (4): 828–31 (In Russ.).Глазко Н.Г., Егоров А.Е. Мониторинг эффективности нейропротекторной терапии глаукомной оптической нейропатии по данным ОКТ-ангиографии. Клиническая офтальмология. 2020; 20 (1): 2–7.Глазко Н.Г., Егоров А.Е. Мониторинг эффективности нейропротекторной терапии глаукомной оптической нейропатии по данным ОКТ-ангиографии. Клиническая офтальмология. 2020; 20 (1): 2–7.Glazko N.G., Egorov A.E. Monitoring the effectiveness of neuroprotective therapy for glaucomatous optic neuropathy according to OCT angiography. Clinical ophthalmology. 2020; 20 (1): 2–7 (In Russ.). doi: 10.32364/2311-7729-2020-20-1-2-7Glazko N.G., Egorov A.E. Monitoring the effectiveness of neuroprotective therapy for glaucomatous optic neuropathy according to OCT angiography. Clinical ophthalmology. 2020; 20 (1): 2–7 (In Russ.). doi: 10.32364/2311-7729-2020-20-1-2-7Глазко Н.Г., Егоров А.Е. Анализ состояния микроциркуляторного русла центральной зоны сетчатки у больных глаукомой при проведении нейроретинопротекторной терапии. Клиническая офтальмология. 2021; 21 (1): 3–8.Глазко Н.Г., Егоров А.Е. Анализ состояния микроциркуляторного русла центральной зоны сетчатки у больных глаукомой при проведении нейроретинопротекторной терапии. Клиническая офтальмология. 2021; 21 (1): 3–8.Glazko N.G., Egorov A.E. Analysis of the state of the microvasculature of the central zone of the retina in patients with glaucoma during neuroretinoprotective therapy. Clinical ophthalmology. 2021; 21 (1): 3–8 (In Russ.). doi: 10.32364/2311-7729-2021-21-1-3-8Glazko N.G., Egorov A.E. Analysis of the state of the microvasculature of the central zone of the retina in patients with glaucoma during neuroretinoprotective therapy. Clinical ophthalmology. 2021; 21 (1): 3–8 (In Russ.). doi: 10.32364/2311-7729-2021-21-1-3-8Rahić O, Tucak A, Omerović N, et al. Novel drug delivery systems fighting glaucoma: Formulation obstacles and solutions. Pharmaceutics. 2020; 13 (1): 28. doi: 10.3390/pharmaceutics13010028Rahić O, Tucak A, Omerović N, et al. Novel drug delivery systems fighting glaucoma: Formulation obstacles and solutions. Pharmaceutics. 2020; 13 (1): 28. doi: 10.3390/pharmaceutics13010028Mead B, Tomarev S. Bone marrow-derived mesenchymal stem cells-derived exosomes promote survival of retinal ganglion cells through miRNA-Dependent Mechanisms. Stem Cells Transl Med. 2017; 6 (4): 1273–85. doi: 10.1002/sctm.16-0428Mead B, Tomarev S. Bone marrow-derived mesenchymal stem cells-derived exosomes promote survival of retinal ganglion cells through miRNA-Dependent Mechanisms. Stem Cells Transl Med. 2017; 6 (4): 1273–85. doi: 10.1002/sctm.16-0428Nuzzi R, Marolo P, Nuzzi A. What is new in glaucoma: From treatment to biological perspectives. J Ophthalmol. 2021. doi: 10.1155/2021/5013529Nuzzi R, Marolo P, Nuzzi A. What is new in glaucoma: From treatment to biological perspectives. J Ophthalmol. 2021. doi: 10.1155/2021/5013529Mead B, Amaral J, Tomarev S. Mesenchymal stem cell-derived small extracellular vesicles promote neuroprotection in rodent models of glaucoma. Invest Ophthalmol Vis Sci. 2018; 59 (2): 702–14. doi: 10.1167/iovs.17-22855Mead B, Amaral J, Tomarev S. Mesenchymal stem cell-derived small extracellular vesicles promote neuroprotection in rodent models of glaucoma. Invest Ophthalmol Vis Sci. 2018; 59 (2): 702–14. doi: 10.1167/iovs.17-22855Pan D, Chang X, Xu M, et al. UMSC-derived exosomes promote retinal ganglion cells survival in a rat model of optic nerve crush. J Chem Neuroanat. 2019; 96: 134–9. doi: 10.1016/j.jchemneu.2019.01.006Pan D, Chang X, Xu M, et al. UMSC-derived exosomes promote retinal ganglion cells survival in a rat model of optic nerve crush. J Chem Neuroanat. 2019; 96: 134–9. doi: 10.1016/j.jchemneu.2019.01.006

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