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Endothelial cell dysfunction may reduce nitric oxide bioavailability and increase reactive oxygen species production, leading to impaired ocular hemodynamics (97), whereas reactive oxygen species can induce cellular senescence and apoptosis (98), which may ultimately lead to optic nerve cell apoptosis, exacerbating optic nerve damage and further exacerbating the progression of glaucoma

Carbonyl stress and endothelial dysfunction entail further pathologies leading to metabolic syndrome 25,26

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