Glaucome et nutrition. Rôle des facteurs nutritionnels au cours des hypertonies oculaires et du glaucome

Oxidative stress, together with uncontrolled balance of long-chain polyunsaturated fatty acids may be involved in ocular hypertonias and glaucoma. Thus, nutritional factors may play a role in the evolution of these diseases. The oxidative stress might be responsible for modifications in the trabeculum extra-cellular matrix. On one hand, apoptosis and collagen remodelling (associated with an increased intraocular pressure) are primarily influenced by hydrosoluble antioxidants such as the glutathione, and on the other hand, apoptosis reactions and elastin remodelling (correlated to the occurrence of optic atrophy) are influenced mainly by liposoluble antioxidants such as vitamin E. Besides, omega 3/ omega 6 fatty acids dietary ratio may modulate the intraocular pressure control. Omega 3 fatty acids compete with the cyclooxygenase. An omega-3-rich and omega-6-poor diet may therefore promote an increased intraocular pressure related to a defect of prostaglandin (PG) F2 synthesis and to a relative decrease in the uveoscleral drainage. To date, the real importance of such factors remains insufficiently determined, but this has been the subject of many publications. Trials are currently carried out to assess the effective involvement of these nutritional factors.