GLAUCOMA OPTIC NEUROPATHY: MODERN METHODS OF EARLY DIAGNOSIS AND PREDICTION OF PROGRESSION

Аннотация

Study of morphological changes in the central parts of the visual analyzer in glaucoma and identification of the role of mitochondrial dysfunction in the development of neurodegenerative changes. study of morphological changes in the central parts of the visual analyzer in glaucoma and identification of the role of mitochondrial dysfunction in the development of neurodegenerative changes. A post-mortem examination was conducted on two people who had glaucoma during their lives and whose deaths were not associated with diseases of the central nervous system. Immunohistochemical examination revealed astrogliosis and beta- amyloid deposits in the cerebral cortex and optic nerve. Structural and functional changes in mitochondria were detected. Degenerative changes in POAG affect both retinal ganglion cells and optic nerve fibers, as well as tissues of the visual analyzer pathways up to the cerebral cortex. Mitochondrial dysfunction may be one of the mechanisms of development and progression of neurodegeneration in primary open-angle glaucoma. Keywords: glaucoma, neurodegeneration, brain, mitochondria. Introduction: to study morphological changes in the central part of the visual analyzer in glaucoma and to determine the role of mitochondrial non-degenerative changes in its development. Primary open-angle glaucoma (POAG) is an age-related disease characterized by a progressive course even against the background of normalized ophthalmotonus [1, 3]. As is known, as in all neurodegenerative diseases, the mechanism of death of retinal cells and optic nerve axons in glaucoma is physiologically programmed apoptosis [3, 4, 6, 12]. Neurodegeneration is characterized by damage to cells and intercellular substance, which leads to organ dysfunction. Neurodegeneration is based on a violation of trophism, that is, a set of mechanisms that ensure the metabolism and preservation of the structure of cells and tissues. 289 NEW RENAISSANCE 2025 MARCH INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE VOLUME 2 | ISSUE 3 Neurodegenerative diseases are diseases that occur as a result of progressive degeneration and death of neurons that are part of certain structures of the central nervous system, leading to disruption of connections between parts of the central nervous system and an imbalance in the synthesis of relevant neurotransmitters, and as a result, a general deterioration in memory, coordination of movements, and thinking. In particular, most such diseases develop in older people. For example, the prevalence of neurodegenerative diseases in patients aged 70-75 years is approximately 5%, and in those over 80 years old it reaches 15%. Modern clinical and experimental research data show that the majority of neurodegenerative diseases are determined by hereditary factors (i.e., the disease is inherited or occurs as a result of pathological mutations of the corresponding genes during life). Common symptoms of neurodegenerative diseases include a long latent period (from 6 to 8-10 years). The most famous of these diseases are Alzheimer's, Parkinson's, Huntington's and Pick's diseases. As the population continues to age in developed countries, the overall prevalence of neurodegenerative diseases shows a clear upward trend [5]. There are diseases that manifest themselves mainly as dementia, such as Alzheimer's disease (atrophy of the gray matter and cholinergic neurons of the brain, cognitive functions (memory, reasoning, etc.) suffer), Pick's disease - a malignant dementia in which the frontal and temporal lobes of the cortex atrophy occurs. There are also diseases with extrapyramidal syndromes, such as Parkinson's disease, in which neurodegeneration of gray matter and dopamine neurons occurs, manifested by movement disorders and tremors. The clinical presentation of Huntington's disease, in which the striatum and cortex atrophy, is characterized by hyperkinesia and mental retardation. Cerebellar degenerations and motor neuron lesions are distinguished, for example, amyotrophic lateral sclerosis, which occurs as a result of degeneration of the motor cortex and manifests itself in the form of paralysis and muscle atrophy. Glaucoma is also one of the neurodegenerative diseases. The development of neurodegeneration in glaucoma combines many factors and pathways of ganglion cell apoptosis, but all of them are somehow related to mitochondria as the main unit responsible for energy processes and apoptosis in the cell. Identifying the role of mitochondrial dysfunction in the development of POAG provides the opportunity to develop neuroprotection on a pathogenetic basis. Let's present facts that may link glaucoma to neurodegenerative diseases. 290 NEW RENAISSANCE 2025 MARCH INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE VOLUME 2 | ISSUE 3 1.General mechanism of cell death: it is known that the death of retinal ganglion cells, as in all neurodegenerative diseases, is a physiologically programmed apoptosis. Apoptosis begins with the activ