Age- and sex-dependency of the association between systemic antioxidant potential and glaucomatous damage

Abstract

Systemic oxidative stress is thought to be an important factor in the pathogenesis of glaucoma. In particular, low systemic antioxidative capacity, which normally counters oxidative stress, may contribute to glaucoma. Thus, we investigated the association between biological antioxidant potential (BAP), a biomarker of systemic antioxidative capacity, and glaucoma severity in patients with open-angle glaucoma (OAG). This study included 480 eyes of 240 patients with OAG and 66 healthy control eyes. We measured the BAP serum level with a free radical analyzer and compared it with a weighted estimate of the number of retinal ganglion cells (wrgc), derived from circumpapillary retinal nerve fiber layer thickness and visual field mean deviation. We found that wrgc was uncorrelated with BAP in the overall, male, and female OAG patients, but was correlated in young (aged ≤ 65 years) male OAG patients (better eye: r = 0.33, P = 0.02; worse eye: r = 0.27, P = 0.047). Furthermore, a mixed-effects regression analysis revealed that BAP was an independent contributing factor to wrgc in young male OAG patients (P = 0.02). Thus, systemic antioxidant capacity was associated with glaucomatous damage in relatively young male patients, suggesting that anti-oxidant therapy might be more effective in these patients.

The association between oxidative stress and corneal hysteresis in patients with glaucoma

“…Tanito et al found that there was no significant difference in dROMs between control and glaucoma groups 17 . In the current study, there were no control subjects, but in a previous study, we found that there were no significant differences in dROMs between controls and any of several OAG subgroups 10 . In the current study, moreover, there was a significant association between dROMs and age in the female OAG patients, but not in the male OAG patients.…”

“…Additionally, female hormones have an antioxidative effect. We previously found that in younger male patients, there was a relationship between reduced BAP and glaucoma severity, but that this relationship was absent in younger female patients 10 . However, after menopause, female subjects with low BAP are susceptible to changes in CH.…”

“…Our findings suggest that systemic antioxidative status may significantly affect the viscoelasticity of the cornea in female OAG patients older than 57 years. In a previous study, we found that sex and age interacted with systemic antioxidative status to influence the pathogenesis of glaucoma and glaucomatous damage 10 . This prompted our decision to separately evaluate male and female groups, as well as older and younger, groups.…”

“…Low systemic antioxidative capacity lowers the ability to defend against oxidative stress, which leads to oxidative damage and higher disease severity in glaucoma 10 . One of the most important antioxidants is glutathione.…”

“…Glaucoma is thought to be a multifactorial disease related to ageing 6 , decreased ocular blood flow 7 , mitochondrial dysfunction 8 , and oxidative stress 9 . Our previous research has revealed that biological antioxidant potential (BAP), a systemic measure of antioxidative potential, is associated with disease severity in younger male glaucoma patients 10 . This prompted the current investigation of the effect of age on BAP and CH.…”