Glaucoma and age-related macular degeneration: challenges and prospects for prevention and treatment of combined pathology. Part 1. Epidemiology and pathogenesis

Glaucoma and age-related macular degeneration are the leading causes of irreversible vision loss in individuals over 60 years of age. This review consolidates current data on the epidemiology, shared genetic factors, and pathophysiological mechanisms underpinning their coexistence, and outlines prospects for personalized prevention and therapy. Common modifiable risk factors comprise cigarette smoking, arterial hypertension, and dyslipidemia. Chorioretinal hypoperfusion, mitochondrial dysfunction, activation of the NLRP3 inflammasome, and impaired glymphatic elimination of amyloid contribute to neurodegeneration both in the macula and in the optic nerve area. Treatment prospects include comprehensive vascular and neuroprotective regimens, targeted complement modulation, and the use of polygenic risk scores for patient stratification and longitudinal monitoring.