E.A. EGOROV 1 , A.V. KUROEDOV 1 , 2 , N.A. GAVRILOVA 3 , A.E. YAVORSKY 4 , E.A. GORNOSTAYEVA 5
1 Pirogov Russian National Medical Research University, Moscow, Russia;
2 Mandryka Central Military Clinical Hospital,
3 Russian University of Medicine, Moscow, Russia;
4 V.P. Vykhodtsev Clinical Ophthalmological Hospital, Omsk, Russia;
5 Zrenie Diagnostic Center, Saint Petersburg, Russia
Place of publication:
Bulletin of Ophthalmology 2025, Vol. 141, No. 4, pp. 49–59
https://doi.org/10.17116/oftalma202514104149
Abstract
The aim of the study . To evaluate the effect of sequential therapy with different doses of Mexidol on the stabilization of glaucomatous optic neuropathy (GON) in patients with primary open-angle glaucoma (POAG).
Material and methods . The study included 80 patients (160 eyes) with POAG stages II and III, who were randomized into 3 groups comparable in age, sex, and the incidence of glaucoma at different stages. All patients received sequential therapy with Mexidol (14 days parenterally, then 90 days orally). The following groups were identified: group 1 - "high dose", group 2 - "low dose", and group 3 - "placebo". In all patients, the mean deviation (MD) and pattern standard deviation (PSD) of retinal light sensitivity were determined before and at therapy completion using static automated perimetry,
and the number of 1st and 2nd order scotomas was recorded. Subgroup analysis of therapy response was performed. The probability of glaucoma progression during therapy was analyzed using the Kaplan-Meier method.
Results . A statistically significant improvement in the MD indicator was revealed at the end of therapy compared with the baseline in the "high-dose" and "low-dose" groups for both advanced (p<0.001) and advanced (p<0.05) stages of POAG. A trend toward an improvement in PSD was noted in the groups of both doses and its absence in the placebo group.
In the placebo group, in contrast to the groups of both doses, a negative trend towards an increase in the relative 1st and 2nd order scotomas was determined. Comparison of treatment response subgroups revealed statistically significant differences for the high, low dose, and placebo groups (p=0.002, Pearson χ2 test). Kaplan-Meier analysis showed a high probability of glaucoma progression in the placebo group and a statistically significantly lower probability (p<0.01) in the low-dose and high-dose Mexidol groups.
Conclusion . Mexidol therapy improves retinal photosensitivity, stabilizes the number of first- and second-order relative scotomas, and reduces the probability of GON progression. A dose-dependent effect of the drug is demonstrated.
Key words: glaucoma, retinal photosensitivity, MD, PSD, scotoma, Mexidol.
