Table 2.

Overview of oxidative-stress-related eye pathologies and antioxidant-based approaches in ophthalmic interventional medicines.

Oxidative-Stress-Related Eye Condition		Oxidative Stress Proposed Mechanism	Antioxidant Ingredients, Drug Formulation, and Mechanism of Action
Ocular surface disease	Dry Eye Disease (DED)	Exposure to highly energetic sunlight wavelengths: ROS production and inflammation in the cornea layers [20].	Antioxidant-based interventional medicine not available to date (for prevention please refer to [18]).
	Cystinosis	Inherited defective metabolism of cystine, which is the oxidized dimer of cysteine, leads to cystine crystal accumulation in the cornea [66].	- Cysteamine (hydrochloride salt): eye drops or gel → reduction of cystine disulphide bond [67].
Lens-related pathologies	Presbyopia	Alteration of viscoelastic properties and increased stiffness of the lens due to oxidative stress exposure [22].	- α-Lipoic Acid Choline Ester: eye drops, pro-drug able to cross the cornea layers → reduction of lens proteins’ disulfide bonds and increase in lens elasticity [68].
	Cataract	Oxidation and unfolding of lens crystallins proteins [69].	- GSH: irrigation solutions for IOL-based surgeries → direct scavenger of hydroxyl radical and superoxide [70].
Glaucoma		Oxidative stress contributes to early deterioration of trabecular meshwork [32].	Antioxidant-based interventional medicine not available to date (for prevention please refer to [18]).
Retinal diseases	Diabetic retinopathy (DR)	Hyperglycemia-induced ROS production induces pathological angiogenesis by different mechanisms, causing retinal ischemia and detachment [71].	Antioxidant-based interventional medicine not available to date (for prevention please refer to [18]).
	Age-related macular degeneration (AMD)	Oxidative stress + UV light + low levels of retinal antioxidants contribute to progressive retina degeneration [72].	Antioxidant-based interventional medicine not available to date (for prevention please refer to [18]).
	Retinitis pigmentosa (RP) and Leber Congenital Amaurosis (LCA)	Inherited induced photoreceptors degeneration causes reduced oxygen consumption in the retina, leading to higher oxygen availability in the outer retina, with consequent ROS production and cone cell death.	- Zuretinol Acetate: Via oral administration, it combines with opsin to form isorhodopsin, starting the redox reactions of the photo-transduction cascade → attenuation of photoreceptors degeneration. - DHA: oral administration → boosting of retinal antioxidant endogenous arsenal.
Iatrogenic oxidative stress	Oxidative stress induced by refractive and vitreoretinal surgery	- ROS production induced by surgical manipulation and light probes. - Surgical removal of eye tissues naturally endowed with antioxidants.	- GSH: irrigation solutions for eye surgeries → scavenger of free radicals and ROS [70]. - Xantophylls (Lutein and Zeaxanthin): dyes in PPV → absorb blue light and interact with oxidized primary scavengers, regenerating their antioxidant ability [73].