Glaucoma is one of the global public health problems. This disease is one of the main causes of irreversible blindness worldwide. Despite progress in therapy and increased effectiveness of methods and measures to reduce intraocular pressure (IOP) and surgical methods, the disease remains poorly controlled due to asymptomatic course in the early stages and poor coverage of early diagnosis, especially in countries with poorly developed economies.

According to WHO, in 2020, glaucoma caused blindness in 3.61 million people and severe visual impairment in 4.14 million, especially in people over 50 years of age. Given that glaucoma is incurable but potentially controllable, early diagnosis and neuroprotective strategies aimed at preserving the optic nerve are of particular importance.

Scientific novelty: This article is devoted to the analysis of modern approaches to neuroprotection in glaucoma, issues of early diagnostics and the potential for integrating these areas into public health strategies. If glaucoma is considered not only as an ophthalmological but also as a neurodegenerative disease based on multifactorial death of retinal ganglion cells (RGC), this shifts the emphasis from exclusively hypotensive therapy to the need for neuroprotective strategies, which reflects the modern vector in the pathogenesis and treatment of glaucoma.

A conclusion is made about the relevance of developing and implementing neuroprotection methods and in-depth screening to improve the effectiveness of combating glaucoma at early stages. The need for a combined approach to treatment adapted to the molecular mechanisms of damage in a particular patient is substantiated, which corresponds to the modern paradigm of personalized medicine.

Glaucoma, intraocular pressure, primary open-angle glaucoma

Aprelev A.E., Pidodniy E.A. Primary neuroprotection of glaucoma https://cyberleninka.ru/article/n/pervichnaya-neyroprotektsiya-glaukomy

Chuprov A.D., Aprelev A.E., Gorbunov A.A., Pidodniy E.A. Neuroprotection in glaucoma. https://science-education.ru/article/view?id=30715

Wang L.-H., Huang C.-H., Lin I.-C. (2024). Advances in Neuroprotection in Glaucoma: Pharmacological Strategies and Emerging Technologies. https://www.mdpi.com/1424-8247/17/10/1261

Pei K., Georgi M., Hill D., Lam C. F. J., Wei W., Cordeiro M. F. (2024). Review: Neuroprotective Nanocarriers in Glaucoma. Pharmaceuticals 17(9):1190. https://doi.org/10.3390/ph17091190

Lee H.-P., Tsung T.-H., Tsai Y.-C., Chen Y.-H., Lu D.-W. (2024). Glaucoma: Current and New Therapeutic Approaches. Biomedicines, 12(9):2000. https://doi.org/10.3390/biomedicines12092000

Xia Q., Zhang D. (2024). Apoptosis in glaucoma: A new direction for the treatment of glaucoma (Review). Molecular Medicine Reports 29:82. https://doi.org/10.3892/mmr.2024.13207

Lisa M. Young, OD, FAAO Glaucoma Facts and Stats https://glaucoma.org/articles/glaucoma-facts-and-stats?utm_source=chatgpt.com

Global estimates on the number of people blind or visually impaired by glaucoma: A meta-analysis from 2000 to 2020

https://www.nature.com/articles/s41433-024-02995-5?utm_source=chatgpt.com

Zhang J., Tian B., Tian M., Si X., Li J., Fan T. (2025). A scoping review of advancements in machine learning for glaucoma: current trends and future direction. Frontiers in Medicine 12:1573329.

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1573329/full

Dal Monte, M.; Cammalleri, M.; Pezzino, S.; Corsaro, R.; Pescosolido, N.; Bagnoli, P.; Rusciano, D. Hypotensive effect of a nanomicellar composition of melatonin and agomelatine in a rat model: implications for glaucoma therapy.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7151109/