The Role of Oxidative Status in the Pathogenesis of Primary Open-Angle Glaucoma, Pseudoexfolyation Syndrome and Glaucoma

Abstract

Purpose To investigate the role of oxidative stress and antioxidant system in the etiopathogenesis of pseudoexfoliation and progression of pseudoexfoliation syndrome to glaucoma. Material and method A total of 20 patients with pseudoexfoliation syndrome, 20 with pseudoexfoliation glaucoma, 20 with primary open-angle glaucoma, and 20 without pseudoexfoliation and glaucoma as a control group, who underwent cataract or glaucoma surgery between December 2020 and March 2021 in the Health Sciences University Beyoğlu Eye Training and Research Hospital, 80 patients were included in the study. Best corrected visual acuity (BCVA), intraocular pressure with applanation tonometry, detailed anterior and posterior segment examinations with biomicroscopy were performed in all patients included in the study. Approximately 0.1 cc of anterior chamber fluid was taken from all patients at the beginning of surgery. Total Oxidant Status (TOS) and Total Antioxidant Status (TAS) levels were measured by keeping the samples taken in the deep freezer of the cornea bank at −80 degrees, transferring them with cold chain transport rules, and examining them with automatic measurement method in the laboratories of the Medical Biochemistry Department of the University of Health Sciences. Oxidative Stress Index (OSI) value was calculated to measure the degree of oxidative stress. Results TAS averages of the control and POAG groups were found to be statistically significantly higher than the PES and PEG groups (p = 0.0001, p = 0.0001). No significant difference was observed between the other groups (p > 0.05). The TOS averages of the control and POAG groups were found to be statistically significantly lower than the PES and PEG groups (p = 0.003, p = 0.0001; p = 0.01, p = 0.001), no statistically significant difference was observed between the other groups (p > 0.05). The OSI mean of the control and POAG groups was found to be statistically significantly lower than the PES and PEG groups (p = 0.001, p = 0.0001; p = 0.002, p = 0.0001), no statistically significant difference was observed between the other groups (p > 0.05). Conclusion Increased TOS and OSI and decreased TAS levels in the aqueous humour of patients with PES and PEG suggest that increased oxidative stress and decreased antioxidative defense system play a role in the etiopathogenesis of the disease.

The use of calprotectin and other inflammatory parameters in the investigation of pseudoexfoliation syndrome concomitant glaucoma and systemic diseases

“…Oxidative stress (OS) and hypoxia occurring in the tissue are the main factors activating the pathophysiologic process in PEX-S.[ 3 ] OS caused by impaired local oxidative/antioxidative balance results in local inflammation, thereby leading to proinflammatory cytokines being released and the inflammatory reaction being activated. [ 26 27 ] In fact, this inflammation is the outcome of the cumulative effect of OS and impaired endothelial function. Since inflammation in PEX-S is more of a localized inflammation, sensitive inflammatory markers that specifically indicate localized inflammation will be more useful to detect the inflammation present.…”

Exosome-based crosstalk in glaucoma pathogenesis: a focus on oxidative stress and neuroinflammation

“…Glaucoma is a multifactorial disease characterized by progressive damage to the retinal ganglial cells (RGCs) and consequent visual impairment (1). Many pathological processes, including oxidative stress, chronic neuroinflammation, mechanical damage with elevated intraocular pressure (IOP), mitochondrial dysfunction, impaired micro-circulation, and extracellular matrix remodeling have been found to contribute to its irreversible damage to the retina yet the associated mechanisms remain elusive (2)(3)(4). Due to the complexity, chronicity, and irreversibility of glaucoma, current medical and surgical treatment which is mainly based on IOP management fail to provide sufficient efficacy in a number of patients who progress to end-stage glaucoma and suffer from poor vision and chronic pain (5).…”

Pseudoexfoliative Syndrome in Cataract Surgery—A Quality Register Study and Health Economic Analysis in the Split-Dalmatia County, Croatia

“…The exact etiopathogenesis of this condition is not yet completely understood, but it is considered a multifactorial disorder that develops through a complex interplay of environmental factors, such as UV exposure and geographic latitude, dietary factors, viral infection and trauma involving the anterior segment of the eye, along with genetic predisposition. Current studies have shown that factors associated with oxidative stress and antioxidant defense mechanisms can play important roles in the etiopathogenesis of PEX [ 10 , 11 ]. Recently, mutations in the lysyl oxidase-like 1 gene ( LOXL1 ) at the locus 15q22 have been identified as the major contributing factor to the fibrotic disorder seen in PEX syndrome [ 12 , 13 ].…”