Lebensstiländerungen im Alter und ihr potenzieller Einfluss auf das primäre Offenwinkelglaukom

Zusammenfassung

Das primäre Offenwinkelglaukom ist eine primäre Mitochondriopathie, die über den oxidativen Stress zu einer Neuroinflammation führt und später in eine Neurodegeneration übergeht. Dabei sind neben dem visuellen System zahlreiche weitere Hirnareale betroffen. Da es beim Altern im Rahmen einer mitochondrialen Dysfunktion ebenfalls zu einer niedriggradigen chronischen Entzündungsreaktion kommt (Inflamm-Aging), überlagern sich diese entzündlichen Prozesse im Alter und verstärken die glaukomassoziierten pathophysiologischen Vorgänge. Um aktiv diesen Entzündungsereignissen entgegenzuwirken, soll die Therapie von vorhandenen Systemerkrankungen optimiert, die Chronobiologie eingehalten und das Mikrobiom verbessert werden. Hierfür unterstützend sind eine erhöhte physische und mentale Aktivität. Somit ist neben einer personalisierten zieldruckorientierten Augeninnendrucksenkung auch eine holistische Sichtweise erforderlich, um der Neurodegeneration primäres Offenwinkelglaukom therapeutisch gerecht zu werden.

Fazit

Bereits bekannt:

• Erhöhtes Alter ist ein Risikofaktor für das POWG.

• Das Älterwerden ist ein sehr komplexer Prozess.

• Bekannte Maßnahmen zur Verlangsamung des Alterns sind eine optimale Therapieeinstellung der vorliegenden Systemerkrankungen sowie physische und mentale Aktivität.

Neu beschrieben:

• Das POWG zählt zu den neurodegenerativen Erkrankungen.

• Das Altern führt zu einer chronischen subklinischen Entzündung (Inflamm-Aging).

• Neue Schwerpunkte zur Verlangsamung des Alterns sind eine Einhaltung von chronobiologischen Abläufen und die Aufrechterhaltung eines gesunden enteralen Mikrobioms.

Conclusion

Already known:

• Increased age is a risk factor for POAG.

• Aging is a highly complex process.

• Familiar measures towards slowing down aging include optimised therapy for manifest systemic diseases as well as physical and mental activity.

New:

• POAG is a neurodegenerative disease.

• Aging leads to chronic subclinical inflammation, known as inflammaging.

• New areas of focus for slowing down aging include maintaining chronobiological processes and maintaining a healthy enteral microbiome.

Schlüsselwörter

Glaukom - Altern - Neurodegeneration - Chronobiologie - Mikrobiom - physische Aktivität

Publikationsverlauf

Eingereicht: 17. Dezember 2023

Angenommen: 19. Juli 2024

Artikel online veröffentlicht:
27. August 2024

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