[en] Purpose: To assess the effects of antioxidant oral supplementation based on docosahexaenoic acid (DHA) in pseudoexfoliative (PEX) glaucoma. Patients and Methods: A prospective 6-month open-label randomized controlled trial was conducted in patients with PEX glaucoma and adequate intraocular pressure (IOP) control. Patients in the DHA group received a high-rich DHA (1 g) nutraceutical formulation. Ophthalmological examination, DHA erythrocyte membrane content (% total fatty acids), plasma total antioxidant capacity (TAC), plasma malondialdehyde (MDA), and plasma IL-6 levels were assessed. Results: Forty-seven patients (DHA group 23, controls 24; mean age 70.3 years) were included. In the DHA group, the mean IOP in the right eye decreased from 14.7 [3.3] mmHg at baseline to 12.1 [1.5] mmHg at 6 months (P=0.01). In the left eye, IOP decreased from 15.1 [3.3] mmHg at baseline to 12.2 [2.4] mmHg at 6 months (P=0.007). DHA erythrocyte content increased in the DHA group, with significant differences versus controls at 3 months and 6 months (8.1% [0.9] vs. 4.4% [0.7]; P < 0.0001). At 6 months and in the DHA group only, TAC levels as compared with baseline increased significantly (919.7 [117.9] vs. 856.9 [180.3] µM copper-reducing equivalents; P=0.01), and both MDA (4.4 [0.8] vs. 5.2 [1.1] nmol/mL; P = 0.02) and IL-6 (2.8 [1.3] vs. 4.7 [2.3] pg/mL; P=0.006) levels were lower than in controls. Conclusions: Targeting pathophysiology mechanisms of PEX glaucoma by reducing oxidative stress and inflammation with a high-rich DHA supplement might be an attractive therapeutic approach. Despite the short duration of treatment, decrease in IOP supports the clinical significance of DHA supplementation.

[gl] Propósito: Avaliar os efectos da suplementación oral antioxidante baseada no ácido docosahexaenoico ( DHA) no glaucoma pseudoexfoliativo ( PEX). Pacientes e métodos: Realizouse un ensaio controlado aleatorio prospectivo aberto de 6 meses en pacientes con glaucoma PEX e control adecuado da presión intraocular ( PIO). Os pacientes no grupo de DHA recibiron unha formulación nutracéutica de DHA (1 g) con alto contido de riqueza. Avaliáronse o exame oftalmolóxico, o contido de membrana de eritrocitos de DHA (% de ácidos graxos totais), a capacidade antioxidante total en plasma ( TAC), o malondialdehído en plasma ( MDA) e os niveis plasmáticos de IL-6. Resultados: Incluíronse 47 pacientes (grupo 23 de DHA, controis 24; idade media 70,3 anos). No grupo con DHA, a PIO media no ollo dereito diminuíu de 14.7 [3.3] mmHg ao comezo do estudo a 12.1 [1.5] mmHg aos 6 meses ( P = 0.01). No ollo esquerdo, a PIO diminuíu de 15.1 [3.3] mmHg ao comezo do estudo a 12.2 [2.4] mmHg aos 6 meses ( P = 0.007). O contido de eritrocitos de DHA aumentou no grupo de DHA, con diferenzas significativas en comparación cos controis aos 3 meses e 6 meses (8,1% [0,9] fronte ao 4,4% [0,7]; P <0,0001). Aos 6 meses e só no grupo con DHA, os niveis de TAC en comparación coa liña basee aumentaron significativamente (919.7 [117.9] vs. 856.9 [180.3] µ M de equivalentes reductores de cobre; P = 0.01), e ambos os MDA (4.4 [0.8] vs. 5.2 [1.1] nmol / mL; P = 0.02) e IL-6 (2.8 [1.3] vs. 4.7 [2.3] pg / mL; P = 0.006) os niveis foron máis baixos que nos controis. Conclusións: Dirixirse aos mecanismos fisiopatológicos do glaucoma PEX mediante a redución da tensión oxidativo e a inflamación cun suplemento rico en DHA pode ser un enfoque terapéutico atractivo. A pesar da curta duración do tratamento, a diminución da PIO apoia a importancia clínica da suplementación con DHA.