D. Antioxidants to prevent Glaucoma
1. Glutathione and vitamin E
There appear to be two different pathways of ECM remodelling and apoptosis induction in POAG. The pathway for collagen remodelling and apoptosis induction seems to be exogenously influenced by water-soluble antioxidants, for example, glutathione. The pathway for elastin remodelling and apoptosis induction seems to be influenced by endogenous lipid-soluble antioxidants, for example, vitamin E. Roles can be defined for antioxidants in the two different pathways of ECM remodelling and apoptosis induction. This suggests that antioxidants are important in maintaining cellular homeostasis relevant to the aetiology of POAG, according to the study by Veach J(53).
2. 3-methyl-1,2-cyclopentanedione (MCP), Red wine-polyphenols, Anthocyanoside, Ubiquinone and Melatonin
Glaucomatous optic neuropathy implies loss of retinal ganglion cells, including their axons, and a major tissue remodeling, especially in the optic nerve head. According to the study by the University Hospital Basel, various natural compounds possess potential antioxidative value. Reduction of oxidative stress at the level of mitochondria can be achieved by gingko biloba. Polyphenolic compounds, such as tea, red wine, dark chocolate, or coffee have antioxidative properties. Coffee contains 3-methyl-1,2-cyclopentanedione (MCP), capable of scavenging peroxynitirite. Red wine-polyphenols (e.g., resveratrol), exert vasoprotective effects by inhibiting the synthesis of endothelin-1. Dark chocolate decreases blood pressure and improves endothelium-dependant vasorelaxation. Anthocyanosides (bilberries) owe their antioxidant effects to their particular chemical structure. Other antioxidants include ubiquinone and melatonin(54).
Unfortunately, in the study to examine the relation between dietary antioxidant intake and primary open-angle glaucoma risk in participants aged over 40 years in the Nurses’ Health Study (n = 76,200) and the Health Professionals Follow-up Study (n = 40,284), indicated that the study did not observe any strong associations between antioxidant consumption and the risk of primary open-angle glaucoma(55).
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