Objective. To conduct a comprehensive assessment of morphological and functional changes in patients with isolated and comorbid forms of primary open-angle glaucoma (POAG) and dry age-related macular degeneration (AMD), as well as to compare the effectiveness of different therapeutic strategies.

Materials and Methods. The study included 184 patients (326 eyes) aged 60 to 84 years. Patients were divided into three groups: isolated POAG, dry AMD, and combined POAG + AMD. In patients with the comorbid form, the effectiveness of three treatment regimens was additionally evaluated: prostaglandins, brimonidine, and brimonidine combined with the antioxidant AREDS 2 formulation. Assessment was performed using optical coherence tomography (OCT), OCT angiography, automated perimetry, and multifocal electroretinography (mfERG), followed by statistical data analysis.

Results. The comorbid form of the disease was associated with more pronounced thinning of the retinal nerve fiber layer, ganglion cell layer, macula, and choroid, as well as deterioration of visual field parameters (MD and VFI). The most favorable outcomes in terms of preservation of morphofunctional parameters and the lowest incidence of adverse effects were observed in the combination therapy group (brimonidine + AREDS 2), where stabilization of visual function was achieved in 87% of eyes.

Conclusions. The coexistence of POAG and dry AMD leads to accelerated progression of neurodegeneration. Combination therapy incorporating neuroprotective and antioxidant components demonstrates an advantage in slowing structural deterioration and preserving visual function in patients with this form of comorbid ophthalmic pathology.

Glaucoma, age-related macular degeneration, neurodegeneration

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