University of Wisconsin, Department of Nutritional Sciences, 1415 Linden Drive, Madison, WI 53706, USA.
University of Wisconsin, Department of Ophthalmology and Visual Sciences, 2870 University Avenue, Madison, WI, 53705, USA.
Nutrients. 2019 May 1;11(5):1002. doi: 10.3390/nu11051002.
Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide, and the prevalence is projected to increase to 112 million worldwide by 2040. Intraocular pressure is currently the only proven modifiable risk factor to treat POAG, but recent evidence suggests a link between antioxidant levels and risk for prevalent glaucoma. Studies have found that antioxidant levels are lower in the serum and aqueous humor of glaucoma patients. In this review, we provide a brief overview of the evidence linking oxidative stress to glaucomatous pathology, followed by an in-depth discussion of epidemiological studies and clinical trials of antioxidant consumption and glaucomatous visual field loss. Lastly, we highlight a possible role for antioxidant carotenoids lutein and zeaxanthin, which accumulate in the retina to form macular pigment, as evidence has emerged supporting an association between macular pigment levels and age-related eye disease, including glaucoma. We conclude that the evidence base is inconsistent in showing causal links between dietary antioxidants and glaucoma risk, and that prospective studies are needed to further investigate the possible relationship between macular pigment levels and glaucoma risk specifically.
原发性开角型青光眼（POAG）是全球范围内导致不可逆性失明的主要原因，预计到 2040 年，全球 POAG 患病率将上升至 1.12 亿。目前，眼内压是唯一被证实可改变的 POAG 治疗风险因素，但最近的证据表明，抗氧化剂水平与青光眼发病风险之间存在关联。研究发现，青光眼患者的血清和房水中的抗氧化剂水平较低。在这篇综述中，我们简要概述了氧化应激与青光眼病理之间的关联证据，然后深入讨论了抗氧化剂消耗与青光眼视野丧失的流行病学研究和临床试验。最后，我们强调了抗氧化类胡萝卜素叶黄素和玉米黄质的可能作用，它们在视网膜中积累形成黄斑色素，有证据表明黄斑色素水平与年龄相关性眼病（包括青光眼）之间存在关联。我们的结论是，饮食抗氧化剂与青光眼风险之间的因果关系的证据基础不一致，需要前瞻性研究来进一步调查黄斑色素水平与青光眼风险之间的可能关系。
