Abstract:

Glaucoma is a chronic degenerative disease of the optic nerve and remains a leading 
cause of irreversible blindness worldwide. Although lowering intraocular pressure (IOP) is the 
main therapeutic strategy, numerous clinical and experimental studies have demonstrated that 
oxidative stress (OS) plays a central role in the pathogenesis of the disease and in the 
neurodegeneration of retinal ganglion cells. The aim of this work is to summarize current scientific 
data regarding the impact of oxidative stress on glaucomatous neuropathy and the potential 
protective effects of antioxidants and nutraceuticals. Peer-reviewed publications from 2018–2025 
were analyzed, including review articles, clinical trials, and systematic reviews that explore the 
role of antioxidant compounds, dietary factors, and nutritional supplements in patients with 
glaucoma. In glaucoma patients, elevated levels of oxidative damage markers—malondialdehyde 
(MDA), 4-hydroxynonenal (4-HNE), and 8-hydroxy-2′-deoxyguanosine (8-OHdG)—have been 
observed, together with a decrease in total antioxidant capacity. Nutraceutical supplements 
containing hesperidin, crocetin, Tamarindus indica, Ginkgo biloba, vitamins A, C, and E, and 
palmitoylethanolamide (PEA) have shown improvements in antioxidant status, ocular 
microcirculation, and moderate reduction in IOP. Oxidative stress is a major pathogenic factor in 
glaucoma. The inclusion of antioxidants as an adjunct to conventional therapy may help protect 
retinal cells and slow neurodegeneration. Large-scale, long-term clinical studies are needed to 
determine the optimal doses and combinations of antioxidant compounds. 

Keywords: glaucoma, oxidative stress, antioxidants, nutraceuticals, neuroprotection.  

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