E.A. EGOROV1, A.V. KUROEDOV1, 2, N.A. GAVRILOVA3, A.E. YAVORSKY4, E.A. GORNOSTAYEVA5
1Pirogov Russian National Medical Research University, Moscow, Russia;
2Mandryka Central Military Clinical Hospital,
3Russian University of Medicine, Moscow, Russia;
4V.P. Vykhodtsev Clinical Ophthalmological Hospital, Omsk, Russia;
5Zrenie 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". All patients underwent static automated perimetry to determine the mean deviation (MD) and pattern standard deviation (PSD) of retinal sensitivity before and after therapy
, and the number of first- and second-order scotomas was recorded. A subgroup analysis of response to therapy was performed. The probability of glaucoma progression during therapy was analyzed using the Kaplan-Meier method.
Results. A statistically significant improvement in the MD index was revealed at the end of the therapy course compared with the baseline level in the "high dose" and "low dose" groups, both in developed (p
In the "placebo" group, in contrast to the groups of both doses, a negative trend towards an increase in relative scotomas of the 1st and 2nd order was determined. When comparing the subgroups of the response to therapy, statistically significant differences were found for the "high", "low" dose and "placebo" (p=0.002, Pearson's χ2 criterion). Kaplan-Meier analysis showed a high probability of glaucoma progression in the "placebo" group and a statistically significantly lower probability (p
Conclusion. Therapy with Mexidol helps to improve retinal photosensitivity, stabilize the number of relative scotomas of the 1st and 2nd order, and reduce the likelihood of GON progression. A dose-dependent effect of the drug is demonstrated.
Key words: glaucoma, retinal photosensitivity, MD, PSD, scotoma, Mexidol.
