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The resulting reactive aldehydes, such as 4-hydroxy-2-nonenal (4-HNE) and malondialdehyde (MDA), not only form adducts with DNA and proteins but also act as secondary messengers that modulate signaling and cell death [41, 42]

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noted that they did not exclude patients with mild visual field defect, making their sample more representative of typical IIH, though they performed matching on baseline comorbidities