Prooxidant-antioxidant imbalance in patients at various stages of primary open-angle glaucoma

Objective. To study the patterns of changes in prooxidant-antioxidant imbalance in patients with primary open-angle glaucoma (POAG) at different stages of the disease.

Materials and methods. The study included 100 patients with POAG and 30 relatively healthy individuals. Patients with POAG were divided into three groups depending on the stage of the disease. The assessment of lipid peroxidation (LPO) indicators and antioxidant defense (AOD) parameters in venous blood was performed using spectrofluorometry and spectrophotometry according to standardized methods.

Results. A clear tendency towards an increase in LPO processes and disruption of the AOD with an increase in the stage of POAG was revealed. The content of dienic conjugates in plasma and erythrocytes increased from 46.4 % (p < 0.001) at stage I to 164.0 % (p < 0.001) at stages III—IV, and from 12.8 % (p = 0.011) at stage I to 55.1 % (p < 0.001) at stages III—IV, respectively, compared to control group. An increase in malondialdehyde level was observed as POAG progressed, with the greatest rise in plasma at stages III—IV, amounting to 51.9 % (p < 0.001) compared to controls. The lowest levels of α-tocopherol, retinol, and ceruloplasmin were recorded at stages III—IV, showing reductions of 13.8 % (p = 0.006), 23.5 % (p = 0.023), and 47.5 % (p < 0.001), respectively, compared to healthy individuals. The most significant decrease in reduced glutathione level was noted at stage II, with a reduction of 33.4 % (p = 0.004). Сatalase activity increased from stage I to stages III—IV by 65.5—81.2 % (p < 0.001).

Conclusion. The study revealed the presence of a prooxidant-antioxidant imbalance in POAG, the degree of which increases with increasing severity of the disease. The obtained results confirm the need for stage-oriented approaches to antioxidant therapy.

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