AGE- MACULAR DEGENERATION AND GLAUCOMA. EPIDEMIOLOGICAL AND CLINIC-PATHOGENETIC ASPECTS
Nowadays age-related macular degeneration (AMD) and glaucoma are the main causes of the irreversible loss of sight in the developed countries. The analysis of 5000 of out-patient records of senior patients (over 50 years) has revealed glaucoma in 30.3 %, AMD in 37.94 %, and their combination in 20.3 % cases. In AMD, the structure signs of the dry form of the disease are diagnosed in 74 % of the cases, the geographical atrophy in 12 % and the wet atrophy ― in 14 %. Primary open-angle glaucoma reduces risk of the wet AMD development while the tendency of early formation of the geographical atrophy of the retina increases and the share of the patients with the wet form goes down to 7 %. The article is intended to scrutinize the main pathogenetic mechanisms of the development of the diseases. Distinctions in the quantitative and qualitative components of biomarkers of the oxidative stress, endothelial dysfunction and inflammation are analysed as predictors of the start and development of comorbid pathology. This allows to identify the risk groups and therapy prospects. The vascular theory of pathogenesis related to the reduction of the perfusion of the head of the optic nerve, retina and chorioidea defines the diagnostic importance of the layer thickness parameters of the peripapillar nervous fibers and ganglion cell in differential diagnostics of this pathology. Application of anti-VEGF to patients with AMD and glaucoma is harmless and does not significantly influence the level of intraocular pressure and intraocular blood circulation. However, it requires careful monitoring of dynamics of the visual-functional and structural changes of the retina and optic nerve, as well as timely therapy correction. A combined course of the diseases with neurodegenerative nature of lesion leads to decrease of not only visual, but also cognitive functions, significantly influences of the senior age group patients’ quality of life and their adaptation in society.
About Authors (Correspondence):
Fursova A.Zh. – doctor of medical sciences, head of department, Novosibirsk State Region Hospital, e-mail: email@example.com