Efficacy of complex neuroprotection in glaucomatous optic neuropathy
DOI:
https://doi.org/10.31288/oftalmolzh201853238Keywords:
glaucomatous optic neuropathy, neuroprotection, laser stimulation, nutrition therapyAbstract
Background. The problem of glaucomatous optic neuropathy is not solved regardless the fact that intraocular pressure is stabilized. To manage the glaucomatous process, effective neuroprotection of the ganglion cells is required.
The purpose of the paper was to study the efficacy of complex neuroprotection in patients with glaucomatous optic neuropathy using sequential laser radiation of the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy.
Material and Methods. We followed up 27 patients (43 eyes) with advanced open angle glaucoma, verified glaucomatous optic neuropathy (GON), and stabilized intraocular pressure (IOP). The patients’ age averaged 63.8 (SD; 6.8). A treatment course included 10 every-day sessions of laser stimulation (LS) using a SM-4.3 unit (wavelength, 650 nm; irradiance, 0.4 mW/cm2; treatment timing, 240 s on the papillomacular bundle) and additional directed laser radiation to the optic disc (OD) using a 90 D lens (treatment timing, 60 s). Thereafter, patients received a vitamin supplement with 1 mg resveratrol: one capsule daily for 6 months.
Results. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol in patients with glaucomatous optical neuropathy made it possible to increase visual acuity from 0.65 to 0.82 (by 26%), to increase visual system sensitivity with phosphene current threshold decreased from 84.9 μA to 76 μA (by 10%), to improve ocular blood circulation from 2.4 to 2.6‰ (by 8%), to decrease vasospasm from 26.7 to 21.8% (by 18%), significantly increase overall retinal light sensitivity from 1395.0 to 1709.0 dB (by 23%), and to stabilize the glaucomatous process within six months.
Analyzing the data obtained after a neuroprotective LS course with a subsequent vitamin antioxidant supplementation therapy with reseratrol (1 mg) revealed an apparent correlation between an increase in overall light sensitivity of the retina and an increase in the blood circulation in the eye (rs=0.71, р<0.01) as well as a decrease in threshold current of visual system sensitivity (rs=-0.84, р<0.01).
Conclusions. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol (1 mg) in patients with glaucomatous optical neuropathy contributes to: an increase in visual acuity by 26%; an increase in the visual system sensitivity, evidenced by a decrease of phosphene threshold current by 10%; an improvement in ocular blood flow by 8%; a decrease of intraocular vasospasm by 18%; and a significant decrease in overall retinal light sensitivity by 23%. It also supports: an increase in conduction of optic nerve fibers; an improvement of the papillomacular bundle function; and stabilization of the glaucomatous process withing six months.
References
Guzun OV. [Efficacy of low-intensity laser irradiation in treatment of patients with dry form of central atherosclerotic chorioidal dystrophy: dissertation for Cand. Sc. (Med.): 14.01.18. The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine. Odessa; 2003. Ukrainian.
Guzun OV, Khramenko NI. Efficacy of laser stimulation of the retina with subsequent nutrient supplementation for treatment of asthenopia in students. J.ophthalmol.(Ukraine).2018;1:19-25 https://doi.org/10.31288/oftalmolzh201811925
Kiseleva TN, Chudin AV, Shchipanova AI, Khoroshilova-Maslova IP. [The impact of resveratrol on ocular microcirculation and structural changes in an experimental model of ischemia-reperfusion of the retina]. ROZh.2016;9(3):66-75. Russian.
Neroev VV, Kiseleva TN, Chudin AV, Shchipanova AI, Ramazanova KA. [Assessing resveratrol effect on ocular blood flow in experiment]. Vestn Oftalmol. 2016;2:55-61. Russian.https://doi.org/10.17116/oftalma2016132255-61
Antonio ML, Laura R, Annagrazia A, Tiziana CM, Rossella R. Rational Basis for Nutraceuticals in the Treatment of Glaucoma. Curr Neuropharmacol. 2018;16(7):1004-17.https://doi.org/10.2174/1570159X15666171109124520
Aydemir O, Naziroglu M, Celebi S, Yilmaz T, Kukner AS. Antioxidant effects of alpha-, gamma- and succinate-tocopherols in guinea pig retina during ischemia-reperfusion injury. Pathophysiology. 2004;11(3):167-71.https://doi.org/10.1016/j.pathophys.2004.08.001
Chen H, Yoshioka H, Kim GS, Jung JE, Okami N, Sakata H. Oxidative stress in ischemic brain damage: mechanisms of cell death and potential molecular targets for neuroprotection. Antioxid. Redox Signal. 2011;14:1505-17.https://doi.org/10.1089/ars.2010.3576
Chen T C, Wilensky JT, Viana MA. Long-term follow-up of initially successful trabeculectomy. Ophthalmology. 1997;104(7):1120-5.https://doi.org/10.1016/S0161-6420(97)30174-2
Doucette LP, Rasnitsyn A, Seifi M, Walter MA. The interactions of genes, age, and environment in glaucoma pathogenesis. Surv Ophthalmol. 2015;60(4): 310-26.https://doi.org/10.1016/j.survophthal.2015.01.004
Engler MB. Vascular relaxation to omega-3 fatty acids: comparison to sodium nitroprusside, nitroglycerin, papaverine, and D600. Cardiovasc Drugs Ther. 1992;6:605-10. https://doi.org/10.1007/BF00052562
Flammer J, Orgul S, Costa VP. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res. 2002;21(4):359-93.https://doi.org/10.1016/S1350-9462(02)00008-3
Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol. 2017; Nov 22. doi: 10.1111/php.12864.https://doi.org/10.1111/php.12864
Inman DM, Harun-Or-Rashid M. Front. Metabolic vulnerability in the neurodegenerative disease glaucoma. Neurosci. 2017;11:146.https://doi.org/10.3389/fnins.2017.00146
Jung KI, Kim YC, Park СК. Dietary Niacin and Open-Angle Glaucoma: The Korean National Health and Nutrition Examination Survey. Nutrients. 2018 Mar 22;10(4). pii: E387. https://doi.org/10.3390/nu10040387
Kang JM, Lin S. Ginkgo biloba and its potential role in glaucoma. Curr Opin Ophthalmol. 2018;29(2):116-20.https://doi.org/10.1097/ICU.0000000000000459
Kim HY, Spector AA. N-Docosahexaenoylethanolamine: A neurotrophic and neuroprotective metabolite of docosahexaenoic acid. Mol Aspects Med. 2018; pii: S0098-2997(18)30024-4.
Ko ML, Peng PH, Ma MC, Ritch R, Chen CF. Dynamic changes in reactive oxygen species and antioxidant levels in retinas in experimental glaucoma. Free Radic Biol Med. 2005;39(3):365-73.https://doi.org/10.1016/j.freeradbiomed.2005.03.025
Koch JC, Lingor P. The role of autophagy in axonal degeneration of the optic nerve. Exp Eye Res. 2016;144:81-9.https://doi.org/10.1016/j.exer.2015.08.016
Lee D, Shim MS, Kim KY, Noh YH, Kim H, Kim SY. Coenzyme Q10 inhibits glutamate excitotoxicity and oxidative stress-mediated mitochondrial alteration in a mouse model of glaucoma. Invest Ophthalmol Vis Sci. 2014;55(2): 993-1005.https://doi.org/10.1167/iovs.13-12564
Lee J, Sohn SW, Kee C. Effect of Ginkgo biloba extract on visual field progression in normal tension glaucoma. J Glaucoma. 2013;22(9):780-4.https://doi.org/10.1097/IJG.0b013e3182595075
Leske MC, Wu SY, Hennis A. Risk factors for incident open-angle glaucoma: the Barbados Eye Studies. Ophthalmology. 2008;115(1):85-93.https://doi.org/10.1016/j.ophtha.2007.03.017
Liang HL, Whelan НТ, Eells JT, Meng Y, Buchmann E, Lerch-Gaggl A, Wong-Rile M. Photobiomodulation partially rescues visual cortical neurons from cyanide-induced apoptosis. Neuroscience. 2006 May 12;139(2):639-49.https://doi.org/10.1016/j.neuroscience.2005.12.047
Miyauchi O, Mizota A, Adachi-Usami E, Nishikawa M. Protective effect of docosahexaenoic acid against retinal ischemic injury: an electroretinographic study. Ophthalmic Res. 2001;33(4);191-5.https://doi.org/10.1159/000055669
Mozaffarieh M, Grieshaber МС, Flammer J. Oxygen and blood flow: players in the pathogenesis of glaucoma. Mol Vis. 2008;14:224-33.
Nakazawa T, Nakazawa С, Matsubara А, Noda К, Hisatomi Т, She Н. Tumor necrosis factor-alpha mediates oligodendrocyte death and delayed retinal ganglion cell loss in a mouse model of glaucoma. J Neurosci. 2006;26(49):12633-41.https://doi.org/10.1523/JNEUROSCI.2801-06.2006
Nucci C, Martucci A, Cesareo M, Garaci F, Morrone LA, Russo R. Links among glaucoma, neurodegenerative, and vascular diseases of the central nervous system. Prog Brain Res. 2015;221:49-65.https://doi.org/10.1016/bs.pbr.2015.04.010
Nucci C, Russo R, Martucci A, Giannini C, Garaci F, Floris R. New strategies for neuroprotection in glaucoma, a disease that affects the central nervous system. Eur J Pharmacol. 2016;787:119-126.https://doi.org/10.1016/j.ejphar.2016.04.030
Osborne NN, Chidlow G, Layton CJ. Optic nerve and neuroprotection strategies. Eye (Lond). 2004;18(11):1075- 84.https://doi.org/10.1038/sj.eye.6701588
Owaifeer AM, Taisan AА. The Role of Diet in Glaucoma: A Review of the Current Evidence. Ophthalmol Ther. 2018; Jun 7(1):19-31.https://doi.org/10.1007/s40123-018-0120-3
Rajendram R, Rao NA. Neuroglobin in normal retina and retina from eyes with advanced glaucoma. Br J Ophthalmol. 2007;91(5):663-6.https://doi.org/10.1136/bjo.2006.093930
Ritch R. Neuroprotection: Is it already applicable to glaucoma therapy? Curr. Opin. Ophthalmol. 2000;11:78-84.https://doi.org/10.1097/00055735-200004000-00002
Saccà SC, Cutolo CA, Ferrari D, Corazza P, Traverso CE. The Eye, Oxidative Damage and Polyunsaturated Fatty Acids. Nutrients. 2018;24;10(6). - pii: E668. https://doi.org/10.3390/nu10060668
Salehpour F, Farajdokht F, Erfani M, Sadigh-Eteghad S, Shotorbani SS, Hamblin MR, Karimi P, Rasta SH, Mahmoudi J. Transcranial near-infrared photobiomodulation attenuates memory impairment and hippocampal oxidative stress in sleep-deprived mice. Brain Res. 2018;1;1682:36-43. https://doi.org/10.1016/j.brainres.2017.12.040
Song W, Huang P, Zhang C. Neuroprotective therapies for glaucoma. Drug Des Devel Ther. 2015;9:1469-79.https://doi.org/10.2147/DDDT.S80594
Tezel G, Wax MB. Hypoxia-inducible factor 1alpha in the glaucomatous retina and optic nerve head. Arch Ophthalmol. 2004;122(9):1348-56.https://doi.org/10.1001/archopht.122.9.1348
Wan MJ, Daniel S, Kassam F. Survey of complementary and alternative medicine use in glaucoma patients. J Glaucoma. 2012;21(2):79-82.
Wang Y, Huang C, Zhang H, Wu R. Autophagy in glaucoma: Crosstalk with apoptosis and its implications. Brain Res Bull. 2015;117:1-9.https://doi.org/10.1016/j.brainresbull.2015.06.001
Yanagi M, Kawasaki R, Wang JJ, Wong TY, Crowston J, Kiuchi Y. Va
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