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CoQ10, vitamin E may reduce oxidative stress in glaucoma
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Treatment with topical coenzyme Q10 and vitamin E showed efficacy in reducing the level of an oxidative stress marker in patients with pseudo-exfoliative glaucoma.
The association of pseudoexfoliation syndrome (PEX) and pseudo-exfoliative glaucoma (PEG) with oxidative stress and its products has been proved in several studies. Oxidative stress also appears to have a role in the degenerative processes that make PEX transition to PEG.
In this study, the effects of coenzyme Q10 (CoQ10) and vitamin E, well known for their antioxidant and neuroprotective properties, were tested in patients with PEG. Sixty-four eyes of 64 patients with PEX or PEG who were scheduled for cataract surgery were included.
One group of patients with PEG received topical CoQ10 and vitamin E (Coqun, Visufarma) for 1 month prior to surgery in addition to their routine prostaglandin monotherapy. Results were compared with those of patients with PEG and patients with PEX who did not receive the Coqun drops.
Before cataract surgery, an aqueous humor sample was aspirated from the anterior chamber of each patient, and the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured.
Significant higher levels of SOD were found in patients with PEG as compared with PEX, which is “reasonable,” according to the authors, because PEG is an advanced form of PEX. Among patients with PEG, those treated with Coqun had significantly lower level of SOD than those who did not receive the treatment (26.9+13.5 U/mL vs. 40.9+14.7 U/mL). No significant differences were observed between the groups regarding MDA levels.
“This result may indicate possible effect of topical CoQ10 and vitamin E on SOD level,” the authors wrote. “Further investigations with a higher number of human subjects and animal models should be conducted in order to extend and prove our suggestion.”– by Michela Cimberle
Disclosure: None of the authors reported a relevant financial disclosure.
Perspective
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Carl H. Jacobsen, OD, FAAO
Psuedoexfoliative glaucoma (PXG) management is quite challenging. This condition responds poorly to topical treatment. PXG also progresses faster and needs filtering surgery earlier and more often than other glaucoma types.
Psuedoexfoliative syndrome (PXS) patients do not have glaucoma, but 50% are destined to convert to PXG. In my medicolegal practice, this is the No. 1 cause of glaucoma-associated malpractice lawsuits. Clearly, we can use all the help we can get in managing this sight-threatening disorder.
Because many studies have found that increased oxidative stress may play a role in glaucomatous optic atrophy, might antioxidants like coenzyme Q10 (CoQ10) and vitamin E play a role in PXG management? Ozates and colleagues take the first steps toward answering this question in this study. Their findings suggest that aqueous oxidative stress marker concentrations are reduced with topical application of CoQ10 and vitamin E.
Of course, increasing aqueous antioxidant concentration has not been shown to slow glaucoma progression, but this finding is still promising. I, for one, will welcome treatments that complement our current IOP-lowering approach. Also, I would love to see a non-eyedrop treatment, and most antioxidants are orally administered. Stay tuned.
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