helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2025-18-4-169-177helmholtzeyeinstitute-1972Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSГеропротективные технологии в профилактике и модифицирующем лечении возраст-ассоциированных заболеваний сетчаткиGeroprotective technologies in the prevention and modifying treatment of age-associated retinal diseasesЗуеваМ. В.ZuevaM. V.

Марина Владимировна Зуева — д-р биол. наук, профессор, начальник отдела клинической физиологии зрения им. С.В. Кравкова, ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава России, ведущий научный сотрудник, ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава России;ФГБУН «Государственный научный центр РФ “Институт медико-биологических проблем Российской академии наук”»

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

Хорошевское шоссе, д. 76а, Москва, 123007

Marina V. Zueva — Dr. of Biol. Sci., professor, head of the department of clinical physiology of vision named after S.V. Kravkov, Helmholtz National Medical Research Center of Eye Diseases, leading reseacher, Institute for Biomedical Problems оf the Russian Academy of Sciences

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

76A, Khoroshevskoe highway, Moscow, 123007

 

visionlab@yandex.ruhttps://orcid.org/0000-0003-4675-9648КотелинВ. И.KotelinV. I.

Владислав Игоревич Котелин — канд. мед. наук, старший научный сотрудник отдела клинической физиологии зрения им. С.В. Кравкова

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

Vladislav I. Kotelin — Cand. of Med. Sci., senior researcher, department of clinical physiology of vision named after S.V. Kravkov

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

https://orcid.org/0000-0003-1038-2746НероеваН. В.NeroevaN. V.

Наталия Владимировна Нероева — д-р мед. наук, начальник отдела патологии сетчатки и зрительного нерва

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

Natalia V. Neroeva — Dr. of Med. Sci., head of the department of pathology of the retina and optic nerve

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

ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава России; ФГБУН «Государственный научный центр РФ “Институт медико-биологических проблем Российской академии наук”»РоссияHelmholtz National Medical Research Center of Eye Diseases; Institute for Biomedical Problems оf the Russian Academy of SciencesRussian FederationФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation202509012026184169177Copyright © Зуева М.В., Котелин В.И., Нероева Н.В., 20262026Зуева М.В., Котелин В.И., Нероева Н.В.Zueva M.V., Kotelin V.I., Neroeva N.V.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/1972

Старение зрительной системы сопровождается снижением зрительных функций и рядом признаков, определяемых генетическими и эпигенетическими изменениями. Исследования показывают, что стратегии, воздействующие на эпигенетические механизмы, могут приводить к ослаблению признаков, связанных со старением, и повышению продолжительности жизни. С другой стороны, замедление старения является важным фактором, который может останавливать или замедлять появление возрастассоциированных заболеваний сетчатки. В многочисленных исследованиях показаны различные молекулярные механизмы, лежащие в основе старения, и предложен ряд основанных на них терапевтических подходов, связанных с эпигенетическими регуляциями. Разработаны геропротективные препараты для замедления старения и сенолитики, направленные на удаление стареющих клеток. Считается, что наилучшие перспективы имеет множественная терапевтическая стратегия, которая включает одновременное применение нескольких препаратов и подходов, направленных на различные аспекты старения. Предполагается, что комбинированное использование различных технологий будет также определять успех генной или клеточной терапии. Многоаспектная терапия представляется наиболее эффективным методом и для замедления старения, и для профилактики или ослабления признаков возрастных заболеваний сетчатки. Поскольку большинство развиваемых сегодня методов находится еще на стадии доклинических или клинических испытаний, наиболее доступными на сегодняшний день (и эффективными) средствами для замедления старения являются технологии здорового долголетия, такие как физическая активность, ограничение калорий и восстановление здоровых биоритмов организма, которые способны оказывать глубокое влияние на все физиологические системы, включая зрительную. Результаты экспериментальных и первых клинических исследований фрактальной оптической стимуляции у больных возрастной макулярной дегенерацией показывают ее перспективность как метода геропротективной терапии и зрительной реабилитации пациентов с возраст-ассоциированными заболеваниями сетчатки для повышения качества жизни и замедления потери зрения.

Aging of the visual system is accompanied by a decline in visual functions and a number of features determined by genetic and epigenetic changes. Studies show that strategies affecting epigenetic mechanisms can lead to a weakening of the features associated with aging and an increase in life expectancy. On the other hand, slowing down aging is an important factor that can stop or decelerate the occurrence of age-associated retinal diseases. Numerous studies have shown various molecular mechanisms underlying aging and proposed a number of therapeutic approaches based on them associated with epigenetic regulations. Geroprotective drugs have been developed to slow down aging and senolytics aimed at removing aging cells. It is recognized that the best prospects are for a therapeutic strategy of multiple approaches, which includes the simultaneous use of several compounds and approaches aimed at different aspects of aging. It is assumed that the combined use of various technologies will also determine the success of gene or cell therapy. Multi-aspect therapy appears to be the most effective method for both decelerating aging and preventing or reducing the signs of age-related retinal diseases. Since most of the methods being developed today are still at the stage of preclinical or clinical trials, the most accessible (and efficient) means for slowing down aging today are healthy longevity technologies, such as physical activity, calorie restriction, and restoration of healthy biorhythms of the body, which are capable of exerting a profound effect on all physiological systems, including the visual system. The results of experimental studies on animals and the first clinical studies of fractal optical stimulation effects in patients with AMD show its promise as a method of geroprotective therapy and visual rehabilitation of patients with age-associated retinal diseases to improve the quality of life and slow down vision loss.

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