# V.E. Korelina ? & I.R. Gazizova ? Abstract-Primary open-angle glaucoma (POAG) remains one of the most controversial eye diseases. Ophthalmologists do not have a consensus on the etiology and pathogenesis of POAG. It is obvious that glaucoma is no longer considered as an exclusively ocular disease associated with impaired hydrodynamics. The search for the causes of the inexorable progression of optic neuropathy has taken researchers far from the eyeball. According to modern concepts, glaucoma is considered as a neurodegenerative disease, located on the border of the professional interests of neurologists and ophthalmologists. Experimental and clinical studies reveal degenerative processes in glaucoma not only in the retina and optic nerve, but throughout the entire visual pathway. Structural changes in the brain in POAG are similar to those in a number of neurodegenerative diseases, for example, Alzheimer's and Parkinson's diseases. These changes correlate with clinical characteristics and severity of glaucoma. More recent studies have shown that neurodegeneration in glaucoma is also associated with neuroinflammatory processes affecting both the retina and brain. Characteristic signs of central nervous system (CNS) degeneration may precede the death of optic nerve fibers. Can neurodegeneration in glaucoma be considered a top-down process, or do events begin to unfold in the retina and gradually move into the brain? [31,41,54]. # Keywords # ????????????????? ? ??????????? ???????????? ???????????? ?????????????? ???????? ??? ???????? ?? ?????? ? ???????? ? ?????????? ?????, ?? ? ?? ???? ?????????? ??????????? ????. [65,88,91,93]. ??????????? ????????? ????????? ????? ??? ???Ð?" ?????????? ??????? ??? ???? ??????????????????? ???????????, ????????, ??????? ??????????? ? ?????????? [81,92]. ??? ????????? ??????????? ? ???????????? ???????????????? ? ???????? ????????. ????? ??????? ???????????? ????????, ??? ???????????????? ??? ???????? ????? ??????? ? ???????????????????? ??????????, ?????????????? ??? ????????, ??? ? ???????? ???? [78]. ??????????? ???????? ??????????? ??????????? ??????? ??????? (???) ????? ?????????????? ?????? ??????? ??????????? ????? [55]. ????? ?? ??????? ???????????????? ??? ???????? ????????? ?????????? ??? ??????? ???????? ??????????????? ? ???????? ? ?????????? ???????????? ? ???????? ??????????? ???????? ????????. # II. # ???????????????? ??? ???? # ??????? ??????????? (??) ? ??????? ?????????? (??) ???????? ???????? ????????????????? ???????????????????? ?????????????. ???????? ???????????????? ???????? ??? ?? ? ?? ????????? ?????????? ?????????????? ???????? ????????? ? ????????? ?????????? ?????: ??????????? (?-???) ??? ??, ???-????? (p-tau) ? ????????? (A?) ??? ?? [62]. ?? ??????????????? ??????? ???????? ? ???????? ? ???? ????????? ?????, ??? ???????? ? ???????????? ????????, ??????????????? ?????? ?????? ? ????????. ?????????????? ?????????? ????? ??????????? ???????? ???????????? ????????? ???????????? (A?) ? ?????????????????? ????????? ??????????????????????? ???-????? (pTau). ??? ????????? ????? ?????????????? ? ???????? ? ?????????? ????? [67]. ?? ???????????? ????? ??????????????????? ???????????? ???????????? ? ??????????????? ??????? ????????????????? ????????. ??? ?????????????? ?????????? ????? ????, ????????? ?? ????????? ???????????. ??? ?? ????? ???????????? ??????????? ????????????????? ?????? ???????? [58]. Ð?"???????, ??????????????????? ??????????? ??????????? ?????, ??????????????? ??????? ??????????? ?????? ???????? (Ð?"??) ? ??????? ?????????? ??????? [85,95]. ??? ?????????? ???, ????? ?????? ?? ?????? ??????, ???????????? ??-??????, ?????????????????? ??? ????????????????, ????? ?????????? ???????????????? ??????? ??????????????? ???????? ? ???????, ?????????? ?????? ?? ?????????. ??-??????, ?????? ????????????? ???? ???????? ? ????? ?????????? ????????? ?????? ? ?????????? ????????. ??? ??? ??????????? ????? ??????????? ??????? ? ????????? ?????????????????, ?????????? ? ?????? ???????. ?????????? ????? ?????????? ?????????????? ? ????????? [16,74,81,92]. ? ????????? ? ???????? ??????????? ???????? ??????????? ? 5 ??? ????, ??? ? ?? ??????????? ?? ??????????? ??????. ???????????? ??? ???? ??????? ????? ?????? ???? ????????? ?????????? ?????????? [14,39]. [34,56]. ? ???? ????? ???????????? ??????????? ?????????? ????? ????? ???? ????? ???????? ?????? ??????????? ???????? [72]. ???? ????? ????????? ??? ? ???????????? ??????? ??????????? ?? ??????? ???????? ? ???????? ??????????? [18], ?? ?????? ????????????? ????????, ??? ???????? ????????? ?????? ? ?????? ???????? ????? ???? ?????????? ??? ?? ?????? ??????? ?????????? ??????? [38] [22]. Ð?"??????????-????????? ???????????? (Ð?"??) ???????????? ????? ????? ???, ?????????? ?? ??????????? ???????? ??????? ???? ? ??????? ???????? ? ???????. ????????? ????????????? ???????? ??????????? ????????????? ? ??????in vivo.?????? ???????????? ??? ???????? ???????? ?????? ?????? ???????? ??????????? ???? ? ????????? ? ?????????. ???????????????? ???????? ?????????? ? ?????????? ?????, ?????????? ??????, ?????????? ?????????? ??????, ?????????? ?????????? ? ?????????? ???? ? ??????? ????????? [21]. ????????????? ????? ??????? ???????????? ????????? ????????? ????? ??????, ?? ????????? ? ????????????? ??????????????????? ??????????????, ??????????? ???Ð?". # III. ???????????????? Ð?"????????? ??? ???Ð?" ???? ???????????????? ?????????? ? ???????? ? ???????????????? ?????????? ?????????? ?????????? ??????? ??????????? ????????? ??????????? [26,27]. ?????? ???????????????? ???? ???????? ?????? ???????????? ???? ???????? ? ??????????? ????? ??? ???????? ??????? ???????? [37,84]. ????????? ??????????? ??? ???Ð?" ???? ???????? ? ????????????????? ? ??????????? ????????????? [23,52]. ?????????? ??????????? ????? ?????? ? ????? ??????????? ?????, ??? ??????????? ?????????? ???????????? ? ??? ?????? ? ??????? ?????????????? ??????????? [76]. ?????? ??? ????? ??????????? ????? ???????? ??????? ? ??????????? ??????????? ?????? ?Ð?"Ð?". ????????????? ?????????????, ??? ???????????????? ?????????? ? ????????? ????? ???????? ????????????????? ???????? ? ???????? ???Ð?" [12,20,35,60,71]. ????????, ??????? ???????????????? Ð?"?? (??Ð?"??) ? ??????? Ð?"??, ??????? ???????? ????? ????????? ???????????, ????? ????????? ? ????????? ????????? ? ??????? ???????????, ??? ????? ??????????? ???????? ? ???????????????? ???Ð?" [48]. ???????????? ??????????? ???????? ???? ? ???????? ???????????????? ? ???????? ?????? ???????? ? ??????????? ????? ??? ????????. ???????????????? [11,33,82]. ? ???????? ?? ???????? ??????? ???????? ?????????. ?? ?????? ?????? ???????, ? ???????? ??????????????? ???????? ???? ?????? ?????? ????????? [42,44,79]. ??????? ??????????? ??????????? ?????????? ???????. ? ?????????? ???????? ?????? ????????, ????? ???????? ?? ???????? ?????????, ?????????? ?????????? ??????????? [68]. ??? ????????? ?????????? ????????? ???????????? ? ???????????? ?????????? ???????? Ð?"?? ?? ????? ???????????. ????????? ??????????? ??????????? ?????, ?????????? ?????????? ? ?????????? ? ??????????. ??? ????????? ???????? ????????????? ?????????? ????????? ? ????????, ?????? ????? ?? ???????????? ??? ??????? ??????? ?????? [43]. ?????????? ??? ?????? ???????? ????????, ????? ????????? ?????????? [45] [61]. ?????? ????????????? ???????? ?? ??????, ??? ????????? ?????-? ????????? ??? ???????? ???????????? ?????? Ð?"?? ? ???????? ????? ?? ?????? ??????? ??????????? ??????? ????? [69]. ??? ??????????????????? ???????????? ??? (????????, ??, ??) ????? ??????? ????????? ?????-? ????????? ? ???????? ??????? ???????????????, ??? ????????? ??????? ? ???????? ??????????? [82]. ???????? ???????? ????? ?????????? ????????, ??????????? ????????? ????????? ? ?????????????? ????? (??????, ??????????? ??????, ??????? ??????? ?????????????? ????????), ? ????? ???????????? ??????????????????? ??????????? ??????????? ? ??????? ??????????????? ?????? [57]. ?????????? ??????? ?????????????? ???????? (?Ð?"Ð?") ?? ????????? ????????????????? ????????? ???????? ???Ð?" ?????????? ????? ????? ?????? ?? ???????? ?????, ?????? ? ??????????? ???????????, ????????????????? ? ????????????? ???????????? ??????????. ?????????, ??? ??????????? ????????? ?Ð?"Ð?" ???????? ? ?????????? ?? ? ?-??? ? Ð?"??, ???, ? ???? ???????, ???????????? ?????? ???????? [29]. ??? ????????. ????????? ?????????????? ????? ???????? 479-486. -https://doi.org/10.18008/1816-5095-?????-? ????????? ?????????? ??? ?????????? ????? 2019-4-479-486????????????? ?????????? ??? ??????? ????????. 99. ????? ??????? ? ?????? ?????????????????? ???????? ????????? ???????? ??????? ?????????????? ????????? ? ?????????? ??????????????????????? ??????????? ????????????? ?????? ???????????????? ???????? ? ???????????????. ??????????? ???????????? ?????????? ????, ??????????????? ????????/ 107-111.????????? ?? ???????????????. 100. ??????????? ???????????????????Ð?"???????, Ð?".?. ??????? // C?????????? ????????????????????? ???????? ??????????, ??????? ? ??????????????? ???????? ??????????????????????????? ? ??????? ??? ?????????? ???????????? ????????? ??????, ????? ?? ??????? ????????????? ?????????, ????? ?????????????: ????????? ???????????, ???, 12-13????????????? ??????? ?? ??????? ????????[99]. ????????????? ???????/ ?????? ?.?. [? ??.] //???????? 2013 ?. -???.: ?????, 2013. -?. 13-14.Year 2023 Medical Research Volume XXIII Issue VIII Version I ( D D D D ) F Year 2023 Medical Research Volume XXIII Issue VIII Version I ( D D D D ) F 34???????? ????????? A? ???????????? ?? ???? ????? ????????, ??????? ???? ??????????? ??????, ???? ??????? ???????, ???? ?????????????? ? ?????????? ????????????? ????, ??? ??? ???????????? ???????????????? ? ?????????? ??? ????? ? ???? ???????? ????????? ? Ð?"?? [73]. ? ???????????? ???????? ?????? ?????????? ????? p-tau, ??????????? A? ? ??????? Ð?"?? [105]. ?????????, ??? ?????????? ?Ð?"Ð?" ??????????? ?????????? ??? ? ?????? Ð?"??, ? ?????????? ??? ??????? Ð?"??. ????? ????, ????????? A? ?????????? ?????? ???????, ??????? ?????????? ????????? ???????? ? ????????? ? ????????? ?????????????? ?????????, ??????? ???????????-1? (IL-1?), IL-6 ? ?????? ??????? ??????? ? (TNF?). ?????? ? A?-????????????? ??? ??? ??????? ??????????? ??????????????, ?????????? ? ?????? Ð?"?? ? ?????????? ???? [89]. ?????????? ?????????? ????-???????? ? ?????? ??????? ??????????? ????? ?????????? ????????? ???????????????? ?????? ? ???????? ?????????????? ????????? ? ?????????? ????? ????? ??????????? ???????????. V. ?????????? ????? ???????, ?????? ???????, ? ??? ????? ????????? ????????? ??????, ???????????????? ??????????, ????????????? ?????? ? ??????? ? ???????? ??????, ????????? ??????? ???????? Ð?"?? ? 89. ????????, ?.?. ?????????????? ????? ?????????????? ?????? ??? ????????????????? ???????? / ???????? ?.?., ???????? ?.?., ???? ?. // ??????????? ?????????????. -2008. -?3. -?. 82-83. 116-121. 95. ??????, ?.?. ????????????? ?????? ??????????????? ????????? ? ?????????? ??????? ????????? ??????? ?????????????; Year 2023 ????????? ?? ????. -2014. -?34(3). -?. 6-12. Financial Disclosure: No author has a financial or property interest in any material mentioned. There is no conflict of interests. ???????????????? 101. ?????????, ?.?. ???????-??????????????? ??????????? ??????????? ???? ??? ???????? ? ??? ??????? ???????????: ??????????? ???. ... ????????? ??????????? ????: 14.01.07 / Medical Research Volume XXIII Issue VIII Version I ( 90. ?. 116-121. -doi: 10.32364/2311-7729-2022-22-2-D D D D )Global Journal of Global Journal of??????????? ??????????? ?????. ????????? ????????? ?? ?????? ????? ?????? ???????? ????, ?? ? ??????????? ???????? ? ??? ??????????? ???????????? ??????, ??????????? ????????? ???????? ? ???????? ??????????? ??????????? ??? ??????. ?????? ??????????????? ?????????? ???????? ??? ????????? ???????? ? ??????? ??????????? /Global Journal of???????????????? ??? ???????? ????????? ?????????????????? ? ?????? ??????????????? ???????? ??????????????? ?????. ?????? ????????? ????????????????? ????????? ?????? ???????? ??????????????? ????????????? ?????????? ???????????????????????? ????????. ?????? ??????????? ??????????????? ?????? ?????? ??????? ? ??????????????? ????? ????????????? ??????????? ????????????.??????????????? ???????? ????? ?? ??????????????????????????????????????????????© 2023 Global Journ als © 2023 Global Journ als F © 2023 Global Journ als Glaucoma as a Neurodegenerative Disease Glaucoma as a Neurodegenerative Disease * Mitochondrial abnormalities in patients with primary open-angle glaucoma / Abu KAbu-Amero KAmero JMorales TBosley 10.1167/iovs.05-1639 Investigative Opthalmology & Visual Science. -2006 47 2533 * Neuroinflammation as a target for glaucoma therapy AAdornetto AAdornetto RRusso VParisi 10.4103/1673-5374.245465 Neural Regen Res 14 3 2019 * Advanced morphological and functional magnetic resonance techniques in glaucoma / Mastropasqua R 10.1155/2015/160454 Biomed Res Int 2015:160454 et al. * TIMP1, and IL-1 Pasa risk factor for the elevated IOP and optic nerve head damage in the primary openangle glaucoma patients / MarkiewiczL 10.1155/2015/812503 Biomed Res Int 9 812503 2015 MMP * Altered large-scale brain functional connectivity in ocular hypertension / Giorgio A 10.3389/fnins.2020.00146 et al. * Visual symptoms in Parkinson's disease / R RAArmstrong 10.4061/2011/908306 * Association between mitochondrial DNA damage and ocular blood flow in patients with glaucoma / Inoue-Yanagimachi M 10.1136/bjophthalmol-2018-312356 British Journal of Ophthalmology 103 8 2019 * Brain morphological alterations of cerebral cortex and subcortical nuclei in high-tension glaucoma brain and its associations with intraocular pressure / Wang Y 62 et al.] // Neuroradiology. -2020 * 10.1007/s00234-019-02347-1 * Degenerative and apoptotic events at retinal and optic nerve level after experimental induction of ocular hypertension / Calandrella N NCalandrella 10.1007/s11010-006-9407-0 Mol Cell Biochem 301 1-2 2007 Scarsella G., Pescosolido N., Risuleo G * Potential and limitations of diffusion MRI tractography for the study of language JSCampbell 10.1016/j.bandl.2013.06.007 / Campbell J.S., Pike G.B. // Brain Lang. -2014 * Changes in gene expression in experimental glaucoma and optic nerve transection: the equilibrium between protective and detrimental mechanisms / Yang Z 10.1167/iovs.07-0542 Invest Ophthalmol Vis Sci et al. * Oxidative stress and mitochondrial dysfunction in glaucoma VChrysostomou VChrysostomou FRezania ITrounce JCrowston Curr Opin Pharmacol 13 1 2013 * Coenzyme Q10 inhibits glutamate excitotoxicity and oxidative stress-mediated mitochondrial alteration in a mouse model of glaucoma/ Lee D 10.1167/iovs.13-12564 Invest Ophthalmol Vis Sci 55 2 2014 * Cognitive dysfunctions in glaucoma: An overview of morpho-functional mechanisms and the impact on higher-order visual function / Arrigo A 10.3389/fnagi.2021.747050 et al. * Ocular manifestations of Alzheimer's and other neurodegenerative diseases: The prospect of the eye as a tool for the early diagnosis of Alzheimer's disease / Colligris P PColligris 10.1155/2018/8538573 Lara M.J., Colligris B., Pintor J. // J Ophthalmol 2018 8538573 * Common aspects between glaucoma and brain neurodegeneration / S.C. 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