Гипотензивная терапия глаукомы и нейропротекция

Большинство современных гипотензивных препаратов, применяемых в лечении первичной открытоугольной глаукомы, оказывают непрямой нейропротекторный эффект не только за счет снижения внутриглазного давления (ВГД), но и из-за стимулирующего воздействия на естественные метаболические процессы в глазу. Исследователи и клиницисты сегодня следуют стратегии компенсации ВГД с самых ранних стадий глаукомной оптической нейропатии (ГОН), независимо от того, какое лекарственное средство (генерическое или оригинальное) и в каком сочетании основных действующих веществ снижает ВГД. Вопрос о необходимости нейропротекторной терапии в клинической практике в основном встает либо в далеко зашедших стадиях ГОН, либо при прогрессирующей потере зрительных функций. Однако, учитывая многофакторный характер заболевания, чрезвычайно важно вовремя, начиная с самых ранних стадий, подключить нейропротекторное лечение. Электрофизиологические и морфометрические исследования могут обеспечить объективный мониторинг нейропротекторной терапии. В целях повышения эффективности лечения в дополнение к гипотензивной терапии необходимо раннее использование прямых нейропротекторов, направленных на защиту от окислительного стресса, эксайтотоксичности и воздействующих на другие молекулярные механизмы глаукомы, для блокирования первичных событий нейродегенерации.

глаукома, компенсация ВГД, прямая и непрямая нейропротекция, генерические препараты, электрофизиологические исследования

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