neuroprotection.

# Alpha-Lipoic Acid in Glaucoma: A Neurovascular Antioxidant Strategy Glaucoma is a **progressive optic neuropathy** in which elevated intraocular pressure, vascular insufficiency, and **oxidative stress** contribute to retinal ganglion cell (RGC) damage ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC3673940/#:~:text=Oxidative%20stress%20has%20been%20implicated,To)) ([www.sciencedirect.com](https://www.sciencedirect.com/science/article/abs/pii/S2173579420300165#:~:text=Taking%20into%20account%20the%20importance,8)). In glaucoma, excessive reactive oxygen species (ROS) and impaired antioxidant defenses lead to DNA, protein, and lipid oxidation in the retina and optic nerve ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC3673940/#:~:text=Oxidative%20stress%20has%20been%20implicated,To)). Augmenting the antioxidant system is therefore of great interest. *Alpha-lipoic acid* (ALA) is a potent, naturally occurring antioxidant that can modulate redox balance and support neurovascular health. It has gained attention for its effects in neurodegenerative and vascular diseases, including diabetic neuropathy and age-related disorders ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC3673940/#:~:text=occurring%20disulfide%20compound%20synthesized%20in,as%20diabetic%20retinopathy%20and%20neuropathy)) ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/38644711/#:~:text=revealed%20that%20%CE%B1LA%20shows%20a,dietary%20intake%20for%20prevention%20and)). Here we review evidence that ALA may reduce oxidative stress, improve endothelial function, and protect optic nerve structure, drawing on animal glaucoma models, human data, and insights from diabetes and aging research. ## Mechanisms of Alpha-Lipoic Acid as an Antioxidant Alpha-lipoic acid (ALA), also known as thioctic acid, is a short-chain sulfur-containing fatty acid synthesized in mitochondria. In its reduced form (dihydrolipoic acid), it **scavenges ROS and reactive nitrogen species**, repairs oxidized lipids and proteins, and *regenerates endogenous antioxidants* like glutathione and vitamins C/E ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC3673940/#:~:text=occurring%20disulfide%20compound%20synthesized%20in,as%20diabetic%20retinopathy%20and%20neuropathy)) ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/18589588/#:~:text=studies%2C%20the%20synergism%20between%20alpha,preventive%20medicine%20and%20human%20nutrition)). ALA is unique in being both fat- and water-soluble, allowing it to distribute widely in tissues and cellular compartments. It also serves as a cofactor in mitochondrial energy metabolism, supporting ATP production in high-demand cells like neurons. Together, these properties suggest ALA can bolster the aging retinal antioxidant defenses and mitigate glaucomatous oxidative damage ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC3673940/#:~:text=occurring%20disulfide%20compound%20sy

Alpha-Lipoic Acid: Redox Modulation and Neurovascular Support in Glaucoma

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