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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ophthalmology</journal-id><journal-title-group><journal-title xml:lang="ru">Офтальмология</journal-title><trans-title-group xml:lang="en"><trans-title>Ophthalmology in Russia</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1816-5095</issn><issn pub-type="epub">2500-0845</issn><publisher><publisher-name>Ophthalmology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18008/1816-5095-2020-3-321-329</article-id><article-id custom-type="elpub" pub-id-type="custom">ophthalmology-1270</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Оптимизация медикаментозного лечения больных глаукомой при сочетании с сопутствующей системной патологией. Часть 1: сердечно-сосудистая патология</article-title><trans-title-group xml:lang="en"><trans-title>Optimization of Medicinal Treatment of Patients with Glaucoma in Combination with Concurrent System Pathology. Part 1: Cardiovascular Pathology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8381-2124</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Журавлева</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhuravleva</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, научный сотрудник отдела глаукомы,</p><p>ул. Садовая-Черногрязская, 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>PhD, Researcher, Glaucoma Department,</p><p>Sadovaya-Chernogriazskaya str., 14/19, 105062</p></bio><email xlink:type="simple">zh.eye@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0161-5010</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зуева</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zueva</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>профессор, доктор биологических наук, начальник отдела клинической физиологии зрения им. С.В. Кравкова,</p><p>ул. Садовая-Черногрязская, 14/19, Москва, 105062</p></bio><bio xml:lang="en"><p>Dr. of Biological Sciences, Professor, Head of the Department of Clinical Physiology of Vision named after S.V. Kravkov,</p><p>Sadovaya-Chernogriazskaya str., 14/19, 105062</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шустов</surname><given-names>Е. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Shustov</surname><given-names>E. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>профессор, доктор медицинских наук, главный научный сотрудник,</p><p>ул. Бехтерева, 1, Санкт-Петербург, 192019</p></bio><bio xml:lang="en"><p>MD, Professor, chief researcher,</p><p>Bekhtereva str., 1, 192019, Saint-Petersburg</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский научно-исследовательский центр глазных болезней им. Гельмгольца» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Helmholtz National Medical Research Center of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУН «Институт токсикологии Федерального медико-биологического агентства России»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Toxicology of FMBA of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>22</day><month>09</month><year>2020</year></pub-date><volume>17</volume><issue>3</issue><fpage>321</fpage><lpage>329</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Журавлева А.Н., Зуева М.В., Шустов Е.Б., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Журавлева А.Н., Зуева М.В., Шустов Е.Б.</copyright-holder><copyright-holder xml:lang="en">Zhuravleva A.N., Zueva M.V., Shustov E.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.ophthalmojournal.com/opht/article/view/1270">https://www.ophthalmojournal.com/opht/article/view/1270</self-uri><abstract><p>В работе представлены клинико-фармакологические взаимодействия лекарственных средств для лечения пациентов, имеющих глаукому в сочетании с сопутствующей сердечно-сосудистой патологией, риски проявлений побочных эффектов и нежелательных лекарственных реакций. Обсуждаются мультифакторность глаукомы и роль возрастного фактора, направления местного и системного патогенетического лечения, принципы персонифицированного подхода и возможности его реализации. Показано, что важным элементом такого подхода может стать система опросников для глаукомных пациентов с хроническими заболеваниями, основное место в которых занимает анкета опросника, заполненная самим пациентом. Цифровая обработка предоставляемых пациентами индивидуальных данных и оценок позволяет реализовать задачи персонифицированного подхода к лечению. Анализ фармакологических эффектов имеющегося и используемого арсенала лечебных препаратов позволяет обобщить массив полученных данных, сформировать модельные алгоритмы для принятия врачом-офтальмологом решения о выборе препаратов. Рассмотрены возможные причины прогрессирования глаукомной оптической нейропатии (ГОН) на фоне связанных с возрастом системных заболеваний (на примере сердечно-сосудистой системы) и предложены пути воздействия — с позиций оптимальной комбинации препаратов — на патогенетические звенья глаукомного процесса. Анализ данных литературы по проблеме структурно-функциональных нарушений при развитии ГОН показывает, что перспективным представляется расширение нашего понимания фундаментальных процессов, лежащих в основе этих изменений, поиск клинически значимых комбинаций современных маркеров изменения структуры и функции и, соответственно, подходов к лечению. Проанализированы возможности нейропротекции ГОН, а также современных методов электрофизиологического исследования в мониторинговой оценке ее эффективности и в дифференциальной диагностике, подходы по усилению эффективности медикаментозного лечения комбинированными препаратами.</p></abstract><trans-abstract xml:lang="en"><p>This paper presents clinical and pharmacological drug interactions for the treatment of patients with glaucoma combined with concurrent cardiovascular pathology, risks of side effects, and adverse drug reactions. The article discusses the multifactor nature of glaucoma, age factors, and the direction of local and systemic pathogenetic treatment, principles of the personified approach, and its feasibility. It is shown that an essential element of this approach can be a system of questionnaires for glaucoma patients with chronic diseases, the principal place in which is occupied by a questionnaire filled out by the patient himself. Digital processing of individual data and assessments provided by patients allows us to implement the tasks of a personalized approach to the treatment. Analysis of the pharmacological effects of the available and used arsenal of medicinal products allows you to generalize the array of data obtained, to form model algorithms for deciding by an ophthalmologist on the choice of medications. In scheme optimizing of the prescribed medications, it is important to cross-inform between specialists of different profiles (ophthalmologists, therapists, neurologists, cardiologists, endocrinologists, rheumatologists, etc.), create an algorithm for entering the medications of choice and their rational combinations, which reduces the risk of polypragmasia. Possible causes of progression of glaucoma optic neuropathy (GON) against the background of age-related systemic diseases (using the example of the cardiovascular system’s pathology) are considered. Ways of influencing the pathogenetic links of the glaucomatous process are proposed from the standpoint of an optimal combination of medications. Analysis of literature on the problem of structural and functional disorders in GON’s development shows that it is promising to expand our understanding of the fundamental processes underlying these changes, search for clinically significant combinations of contemporary markers of changes in structure and function, and, accordingly, treatment approaches. The possibilities of neuroprotection of glaucoma optical neuropathy, as well as modern methods of electrophysiological research in the monitoring assessment of its effectiveness and the differential diagnosis, approaches to enhance the effectiveness of medications treatment with combined medications are analyzed in the article.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>первичная открытоугольная глаукома</kwd><kwd>сердечно-сосудистые заболевания</kwd><kwd>полипрагмазия</kwd><kwd>взаимодействие лекарств</kwd><kwd>патогенетическая терапия</kwd><kwd>нейропротекция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>primary open-angle glaucoma</kwd><kwd>cardiovascular diseases</kwd><kwd>neuroprotection</kwd><kwd>polypragmasia</kwd><kwd>drug interaction</kwd><kwd>pathogenetic therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Онищенко А.Л., Колбаско А.В., Захарова А.В., Онищенко Е.Г., Жилина Н.М. 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