Аntioxidant Status and Lipid Metabolism in Patients with Different Forms of Primary Open-Angle Glaucoma Progression

Abstract

Purpose: to study the antioxidant system and lipid status of serum and evaluate the effect of Cytoflavin on these characteristics in patients with progressive and stable primary open angle glaucoma (POAG).Patients and methods. 67 patients with advanced stage POAG were observed. The average age was 66.3 ± 1.5 years. According to the course of the glaucoma process all patients were randomized into 2 groups: the 1st group with the stable glaucoma (31 patients) and the 2nd group with rapidly progressive glaucoma (36 patients). The progression criteria of POAG were global ganglion cell loss volume (GLV) and perimetric index (mean deviation-MD). For assessment of the reactivity of the vascular endothelium, a test with reactive hyperemia was performed using ultrasound method. The assessment of oxidative stress (OS) including peroxides, malonyldialdehyde (MDA) and the total antioxidant capacity of serum (AOS) were evaluated. The investigations of lipid metabolism included the level of cholesterol total (CT), cholesterol of low-density lipoproteins cholesterol (LDL-C), high-density lipoproteins cholesterol (HDL-C), triglycerides (TG) and atherogenic index (AI).Results. In the 2nd group there was the significant decrease of the mean GLV indices compared to those in the 1st group (7.16 ± 2.5 и 1.06 ± 0.2, respectively, р < 0.001). The mild degree of endothelial dysfunction (ED) predominantly was detected in patients of the 1st group (69 % of cases). The moderate and marked ED were found in patients with progressive POAG (68 and 25 %, respectively). The high level of OS in serum was determined in 43 % of patients of the 1st group and in 69 % of patients of the 2nd group (significant increase of peroxides and MDA). In patients with progressive POAG the mean indices of lipid metabolism (CT, LDL-C, HDL-C, TG, AI) were significantly higher than in healthy subjects (р < 0.001). Cytoflavin had a positive effect on the vascular endothelium function, normalization of lipid metabolism and decrease of OS in serum with increasing AOS in patients with progressive POAG.Conclusion. The assessment of the indices of OS, AOS and lipid metabolism enable us to determine the risk of progression of POAG and evaluate of the effectiveness of treatment.

Assessing factors of endothelial vascular dysfunction in patients with primary open-angle glaucoma

“…In our opinion, lipoproteins and nonesterified fatty acids are the major targets of lipid peroxidation in plasma. Our findings of increased lipid peroxidation in plasma of patients with POAG are in agreement with the reports of others that oxidative stress is an important factor of risk for endothelial dysfunction [14,19,30]. Lipid peroxidation is a physiological process continuously running in living cells.…”

“…Currently, vascular endothelial dysfunction leading to optic disc ischemia and compression of optic nerve axons is a major current theory for the development of POAG [9][10][11][12][13]. Inadequate blood supply to the retina and optic nerve due to poor ocular circulation are important factors of the development and progression of POAG [14][15][16].…”