The effect of antioxidant therapy on some pathogenetic factors of primary open -angle glaucoma

Authors:
T.N. MALISHEVSKAYA¹, Yu.E. FILIPPOVA²

¹Federal State Budgetary Institution "Helmholtz National Medical Research Center for Eye Diseases" of the Ministry of Health of the Russian Federation, Moscow, Russia;
²State Autonomous Healthcare Institution of the Tyumen Region "Regional Ophthalmological Dispensary", Tyumen, Russia

Place of publication:
VESTNIK OPHTHALMOLOGII, No. 4, Vol. 139, 2023

Abstract:
In patients with glaucoma, one of the primary initiating mechanisms triggering the chain of events is a disruption of the universal mechanism regulating vascular tone due to endothelial dysfunction (ED). The primary manifestation of ED is an imbalance of vasoconstrictor and vasodilator endothelial mediators, the discordance of which triggers adaptive distress mechanisms leading to the progression of morphological destruction, dyslipidemia, atherogenesis acecleration, and the development of hemodynamic and hydrodynamic disturbances. Mexidol has a broad spectrum of pharmacological activity, affecting the main pathogenetic links of primary open-angle glaucoma (POAG). Objective: To study the vasoremodulatory, antioxidant, and antihypoxant effects of Mexidol in patients with POAG. Materials and Methods. The study included 78 patients with initial (n=43) and advanced (n=35) primary open-angle glaucoma (POAG), with an average age of 67.8±1.5 years. 47 patients in the main group received Mexidol in addition to local hypotensive treatment, while 31 patients formed the control group. In the comparison groups, the degree of ED was determined based on the results of a reactive hyperemia test, and the level of a stable nitric oxide metabolite (nitrite NO2–) and endothelin-1 in blood plasma was examined. A general assessment of oxidative stress was performed using high-performance liquid chromatography. Studies of the functional activity of the retina were performed using an electroretinograph and static computer perimetry according to a standard technique. Results. Against the background of the use of the drug Mexidol in patients of the main group, the oscillatory potential index significantly increases, the interpeak latency decreases, positive dynamics of perimetric indices, improved vascular endothelial function in the test with reactive hyperemia, a decrease in the concentration of the constrictor mediator ET-1 in the blood plasma, a moderate increase in nitrite (NO2–) and a decrease in the coefficient of bioeffector vasotonic activity are observed, the level of glutathione peroxidase increases (p Conclusion. The drug Mexidol has proven itself as an effective endothelioprotector, a powerful antioxidant and antihypoxant, contributed to the reduction of acecleration factors of atherogenesis in patients with POAG. Key words: primary open-angle glaucoma, endothelial dysfunction, Mexidol.