Modern trends in the treatment of glaucoma

S. Petrov, L. V. Yakubova, O. I. Markelova
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Abstract

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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治疗青光眼的现代趋势
在俄罗斯几乎所有地区,青光眼都是眼科疾病致残原因中的第一位,这与全球青光眼发病率的增长趋势及其在不可逆致盲原因中的领先地位是一致的。治疗青光眼的目的是降低眼压(IOP)。本综述介绍了当前治疗青光眼的主要趋势:药物治疗、激光手术、造瘘、引流和非穿透手术,以及最新的微创青光眼手术(MIGS)。为了提高治疗的依从性,人们提出了固定剂量的联合用药方案,并正在开发有效的给药方法,从而在降低眼压的同时将副作用降到最低。激光手术的进一步发展使其既成为初始治疗的首选方法(选择性激光小梁成形术),又扩大了其在青光眼不同阶段的治疗能力(微脉冲环形光凝术)。所有这些都大大降低了传统的大创面抗青光眼手术的频率。最新的微脉冲环形血管凝固术填补了以往保守药物治疗和抗青光眼手术之间的空白。近年来,在原发性开角型青光眼治疗的各个阶段,都出现了新的药物、方法和植入物。这些正是本出版物的目的所在。
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