The use of Mexidol in the treatment of primary open -angle glaucoma

Authors:
I.A. LOSKUTOV, O.M. ANDRYUKHINA, A.A. KOVRIZHKINA

Moscow Regional Research Clinical Institute. M.F. Vladimir

Place of publication:
EFFECTIVE PHARMACOTHERAPY, 2022

Abstract:
This article focuses on the comprehensive treatment of primary open-angle glaucoma, specifically on understanding the principles of neuroprotection in the pathogenesis of glaucomatous optic neuropathy. Various biochemical reactions involved in retinal nerve fiber layer apoptosis and neurodegeneration are described. Mexidol (ethylmethylhydroxypyridine succinate), a reference (original) antioxidant with a multimodal mechanism of action, is registered and actively used in the Russian Federation. Due to its unique complex molecule—a pyridine base and a derivative of succinic acid—Mexidol is characterized by high bioavailability and the ability to penetrate the blood-brain barrier. The presence of succinate in the molecule also enhances the antioxidant effect, which fundamentally distinguishes the drug from other antioxidant analogues available on the domestic pharmaceutical market. Mexidol's mechanism of action is based on antioxidant, antihypoxic, and membranotropic effects. The use of Mexidol, which affects various components of oxidative stress, is justified in the comprehensive treatment of primary open-angle glaucoma. It is no coincidence that this drug is included in the standard of care for patients with glaucoma. A number of publications containing the results of studies of ethylmethylhydroxypyridine succinate in primary open-angle glaucoma stages I-III were analyzed. A sequential Mexidol therapy regimen with proven efficacy was developed, slowing neurodegeneration and stabilizing visual function in patients with primary open-angle glaucoma. Keywords: glaucoma, Mexidol, antioxidant, neuroprotection, oxidative stress.