Application of physiotherapy in glaucomatous optic neuropathy

Relevance Glaucoma is a neurodegenerative disease characterized by a gradual onset and chronic course, which leads to irreversible loss of visual functions. According to the literature, there is an active increase in the number of identified patients with primary open-angle glaucoma (POAG) and it is expected that by 2040 this pathology will affect 112 million people [1]. With the progression of glaucoma optic neuropathy (GON), atrophic changes are observed at the level of all departments - from the retina to the cerebral hemispheres. The main histopathological sign has always been considered the loss of axons of retinal ganglion cells. However, recent studies have shown that the central nervous system is also involved in the process - as a result of increased IOP, neurons shrink and are lost in the visual cortex of the brain. In order to assess morphofunctional changes in GON, modern research methods such as optical coherence tomography (OCT), where the macula is the newest area of ​​research, and pattern electroretinogram (PERG) are used [2]. Methods of treating glaucoma, both drug and surgical, are aimed at reducing IOP. Currently, complex treatment tactics have been actively introduced - pharmacotherapy with physiotherapeutic or surgical methods. Physiotherapy is aimed at neuroprotection. The most widely used are secondary neuroprotectors, the action of which is aimed at reducing damage processes - blockade of proinflammatory cytokines, inhibition of prooxidant enzymes, enhancement of trophic support and interruption of apoptosis. Physiotherapy methods such as transcutaneous electrical stimulation, magnetic therapy, laser stimulation with the use of drugs that improve blood flow, and low-frequency ultrasound are used. In addition to the above methods, drug electrophoresis (ion therapy, ion galvanization, ion electrotherapy, iontophoresis, dielectrolysis) is actively used. The method of local drug electrophoresis allows achieving stabilization of the clinical effect within 1.5 years, but requires surgical treatment [3, 4]. Conclusion Thus, physiotherapeutic treatment methods aimed at neuroprotection improve the survival of retinal ganglion cells, slowing the progression of the disease, and, moreover, contribute to the restoration of visual functions due to tissue regeneration [5]. Key words: primary open-angle glaucoma; neuroprotection; physiotherapy of glaucoma