Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients

<p> M.V. Tereshchenko<sup>1</sup>, A.E. Egorov<sup>1,2</sup>, A.B. Movsisyan<sup>1,2</sup> </p> <p> <sup>1</sup>Hospital for War Veterans No. 2, Moscow, Russian Federation </p> <p> <sup>2</sup>Pirogov Russi...

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Main Authors: M.V. Tereshchenko, A.E. Egorov, A.B. Movsisyan
Format: Article
Language:Russian
Published: Prime-Media 2022-11-01
Series:РМЖ "Клиническая офтальмология"
Online Access:http://clinopht.com/upload/iblock/c54/1vvq8s9rpf11parkqrinh2sp8hu6grnm.pdf
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author M.V. Tereshchenko
A.E. Egorov
A.B. Movsisyan
author_facet M.V. Tereshchenko
A.E. Egorov
A.B. Movsisyan
author_sort M.V. Tereshchenko
collection DOAJ
description <p> M.V. Tereshchenko<sup>1</sup>, A.E. Egorov<sup>1,2</sup>, A.B. Movsisyan<sup>1,2</sup> </p> <p> <sup>1</sup>Hospital for War Veterans No. 2, Moscow, Russian Federation </p> <p> <sup>2</sup>Pirogov Russian National Research Medical University, Moscow, Russian Federation </p> <p> Glaucoma is one of the socially significant and disabling diseases highly prevalent worldwide. Population ageing and increase in life expectancy will result in even a bigger growth of glaucoma cases. The main principle of medical management of primary open-angle glaucoma (POAG) is to provide a timely ocular hypotensive therapy directed at lowering intraocular pressure, the only modifiable risk factor in the disease progression, to a target level. The article describes specific approaches to the medical management of elderly and senile patients with POAG, taking into consideration age-related eye problems and medications used for comorbidities. The selection of drugs is based on the assessment of their efficacy, probability of adverse events, dosage frequency, convenience of use and the cost of treatment. For a long time, β-adrenergic blocking agents were considered a first line medication for POAG. However, due to the adverse events, including systemic side effects, β-blockers have become second-line drugs for the treatment of elderly and senile patients. First-line medications now include prostaglandin analogues characterized by a higher efficacy and a lower rate of adverse events. The best option for patients with POAG is the use of preservative-free highly selective prostaglandin analogues which reduce intraocular pressure to a target level, maintain patient’s visual functions for a long time, improve the quality of life and cause significantly less adverse reactions on the ocular surface. </p> <p> <b>Keywords</b>: glaucoma, prostaglandin analogues, β-blockers, dry eye syndrome, preservatives, travoprost. </p> <p> <b>For citation: </b>Tereshchenko M.V., Egorov A.E., Movsisyan A.B. Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients. Russian Journal of Clinical Ophthalmology. 2022;22(4):234–239 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-234-239. </p>
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publisher Prime-Media
record_format Article
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spelling doaj-art-bd76fb6e8d7e4438bdf342f7c7b7a0e92025-01-16T09:39:38ZrusPrime-MediaРМЖ "Клиническая офтальмология"2311-77292619-15712022-11-0122431525Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patientsM.V. Tereshchenko0A.E. Egorov1A.B. Movsisyan2Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399Russian Journal of Clinical Ophthalmology, Publisher of «Medicina-Inform» Address for correspondence: Russia, 105064, Moscow, P.O. Box 399<p> M.V. Tereshchenko<sup>1</sup>, A.E. Egorov<sup>1,2</sup>, A.B. Movsisyan<sup>1,2</sup> </p> <p> <sup>1</sup>Hospital for War Veterans No. 2, Moscow, Russian Federation </p> <p> <sup>2</sup>Pirogov Russian National Research Medical University, Moscow, Russian Federation </p> <p> Glaucoma is one of the socially significant and disabling diseases highly prevalent worldwide. Population ageing and increase in life expectancy will result in even a bigger growth of glaucoma cases. The main principle of medical management of primary open-angle glaucoma (POAG) is to provide a timely ocular hypotensive therapy directed at lowering intraocular pressure, the only modifiable risk factor in the disease progression, to a target level. The article describes specific approaches to the medical management of elderly and senile patients with POAG, taking into consideration age-related eye problems and medications used for comorbidities. The selection of drugs is based on the assessment of their efficacy, probability of adverse events, dosage frequency, convenience of use and the cost of treatment. For a long time, β-adrenergic blocking agents were considered a first line medication for POAG. However, due to the adverse events, including systemic side effects, β-blockers have become second-line drugs for the treatment of elderly and senile patients. First-line medications now include prostaglandin analogues characterized by a higher efficacy and a lower rate of adverse events. The best option for patients with POAG is the use of preservative-free highly selective prostaglandin analogues which reduce intraocular pressure to a target level, maintain patient’s visual functions for a long time, improve the quality of life and cause significantly less adverse reactions on the ocular surface. </p> <p> <b>Keywords</b>: glaucoma, prostaglandin analogues, β-blockers, dry eye syndrome, preservatives, travoprost. </p> <p> <b>For citation: </b>Tereshchenko M.V., Egorov A.E., Movsisyan A.B. Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients. Russian Journal of Clinical Ophthalmology. 2022;22(4):234–239 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-234-239. </p>http://clinopht.com/upload/iblock/c54/1vvq8s9rpf11parkqrinh2sp8hu6grnm.pdf
spellingShingle M.V. Tereshchenko
A.E. Egorov
A.B. Movsisyan
Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
РМЖ "Клиническая офтальмология"
title Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
title_full Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
title_fullStr Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
title_full_unstemmed Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
title_short Rational pharmacotherapy of primary open-angle glaucoma in elderly and senile patients
title_sort rational pharmacotherapy of primary open angle glaucoma in elderly and senile patients
url http://clinopht.com/upload/iblock/c54/1vvq8s9rpf11parkqrinh2sp8hu6grnm.pdf
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