Factors in the development of refractory primary open-angle glaucoma (part 2)

Development of primary open-angle glaucoma (POAG) in older patients is associated with a high risk of its refractoriness, which contributes to the progression of the pathological process possibly leading to a severe disabling complication — blindness. Concomitant pathology also makes a significant contribution to the course of primary open-angle glaucoma and requires a careful approach to diagnosis and management. POAG is a multifactorial pathology, so the treatment plan should take into account both genetic predisposition and general somatic pathology, as well as the socio-economic background. Studying the interaction of these factors contributes to a better understanding of the causes and processes that result in the refractory form of POAG. Specifically, the most common pathologies of the cardiovascular system that affect the course of POAG are arterial hypertension (AH) or hypotension, coronary heart disease (CHD), dyscirculatory encephalopathy (DE). In addition, the course of the disease is significantly affected by diabetes mellitus (DM), neurodegenerative pathologies, and smoking. These findings have been confirmed in a number of international multicenter studies. Certain social factors, however, are of particular importance due to mutually exclusive published findings. Notably, the socioeconomic status of patients (for example, the presence or absence of higher education) also plays an important role in the diagnosis and progression of the disease. Detailed consideration of these factors is extremely important for a better understanding of the disease and, consequently, the improvement of the quality of life of patients.