helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2024-17-1-136-143helmholtzeyeinstitute-1442Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSСовременные тенденции в лечении глаукомыModern trends in the treatment of glaucomahttps://orcid.org/0000-0001-6922-0464ПетровС. Ю.PetrovS. Yu.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Sergey Yu. Petrov — Dr. of Med. Sci., head, department of glaucoma

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

glaucomatosis@gmail.comhttps://orcid.org/0000-0002-9991-5600ЯкубоваЛ. В.YakubovaL. V.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Liya V. Yakubova — Cand. of Med. Sci., ophthalmologist, department of glaucoma

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

https://orcid.org/0000-0002-8090-6034МаркеловаО. И.MarkelovaO. I.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Oksana I. Markelova — PhD student, department of glaucoma

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation202426032024171136143Copyright © Петров С.Ю., Якубова Л.В., Маркелова О.И., 20242024Петров С.Ю., Якубова Л.В., Маркелова О.И.Petrov S.Y., Yakubova L.V., Markelova O.I.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/1442

Практически во всех регионах России глаукома занимает 1-е место среди причин инвалидности вследствие офтальмопатологии, что соответствует общемировым тенденциям роста заболеваемости глаукомой и ее лидирующего положения среди причин, приводящих к необратимой слепоте. Лечение глаукомы направлено на снижение внутриглазного давления (ВГД). В данном обзоре представлены основные современные тенденции развития медикаментозной терапии глаукомы, лазерной хирургии, фистулизирующей, дренажной и непроникающей хирургии, а также новейшей микроинвазивной хирургии глаукомы (МИХГ). В настоящее время на фармацевтическом рынке существует множество гипотензивных капель. Для повышения приверженности лечению предложены фиксированные комбинации лекарственных средств, разрабатываются также эффективные способы доставки лекарств, снижающих ВГД при минимальных побочных эффектах. Дальнейшее развитие лазерной хирургии делает ее методом выбора при стартовом лечении (селективная лазерная трабекулопластика), а также расширяет возможности ее применения при различных стадиях глаукомы (микроимпульсная циклофотокоагуляция). Все это существенно снижает частоту классических макроинвазивных антиглаукомных операций. Существовавший ранее разрыв между консервативной медикаментозной терапией и антиглаукомной хирургией призваны заполнить новейшие процедуры МИХГ. В последние годы на всех этапах терапии первичной открытоугольной глаукомы отмечают появление новых фармацевтических препаратов, методов и имплантов, описание которых и стало целью данного обзора.

In nearly all Russian regions, glaucoma ranks first among the causes of disability due to ophthalmic pathology, which is in line with global trends of glaucoma incidence growth and its leading position among the causes of irreversible blindness. Treatment of glaucoma is aimed at lowering intraocular pressure (IOP). This review presents the main current trends in the treatment of glaucoma: drug therapy, laser surgery, fistulizing, drainage and non-penetrating surgery, as well as the latest micro-invasive glaucoma surgery (MIGS).

Currently, the pharmaceutical market offers many antihypertensive drops. Fixed-dose combinations of drugs have been proposed to increase treatment adherence, and effective drug delivery methods are being developed, which lower IOP with minimal side effects. Further development of laser surgery makes it both a method of choice for the initial treatment (selective laser trabeculoplasty) and expands its capabilities for various stages of glaucoma (micropulse cyclophotocoagulation). All this significantly reduces the frequency of classical macroinvasive antiglaucoma operations. The previously existing gap between conservative medical therapy and antiglaucoma surgery is filled by the newest MIHG procedures. In recent years, at all stages of primary open-angle glaucoma therapy, the emergence of new pharmaceuticals, methods and implants has been noted. These constitute the purpose of this publication.

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