11 replies to this topic

[Dizzon]

I'm creating a supplement stack for my mother who has been diagnosed with Glaucoma. So far all supplements that could be beneficial could also be labeled as 'nootropics', which makes a bit of sense since glaucoma is essentially a neurological disorder (regardless of etiology) localized in your head.

So I'm wondering if anyone else has found any relevant information r.e. purchasable supplements for the treatment of glaucoma? Aside from the basic suggested carotenoids such as lutein, zeaxanthin and astaxanthin. Here's what I've gathered so far:

CDP choline (a.k.a. Citicoline)
http://www.ncbi.nlm....pubmed/18929133
http://www.ncbi.nlm....pubmed/12640353
http://www.ncbi.nlm....pubmed/11782957
http://www.ncbi.nlm....pubmed/22165093
http://www.ncbi.nlm....pubmed/10366081
http://www.ncbi.nlm..../pubmed/2744938
http://www.ncbi.nlm....pubmed/16249960

Ginko Biloba
http://www.ncbi.nlm....pubmed/12578781
http://www.ncbi.nlm....pubmed/10790757
http://www.ncbi.nlm....pubmed/22595937
http://www.ncbi.nlm....pubmed/10385132
http://www.ncbi.nlm....pubmed/21976939

Vinpocetine (a.k.a. Cavinton Forte)
http://www.ncbi.nlm....pubmed/19062562
http://www.ncbi.nlm....pubmed/19916330

Picamilon
http://www.ncbi.nlm....pubmed/23808185

Proanthocyanidins (Pycnogenol, Grape Seed Extract and Bilberry Extract, Bilberry being the most studied r.e. Glaucoma)
http://www.ncbi.nlm....pubmed/22870951
http://www.ncbi.nlm....pubmed/18618008

Melatonin (evidence more preliminary than the other supplements aside from GSE and arguably Pycnogenol, no human trials AFAIK)
http://www.ncbi.nlm....pubmed/21073517
http://www.ncbi.nlm....pubmed/20374442

Edited by Dizzon, 15 November 2013 - 09:52 PM.

[AstralStorm]

Neither of those has good enough evidence to really recommend. Cherry picked results do not make for good evidence, but make for good sales.

CDP Choline actually is the strongest of the group, but it doesn't affect intraocular pressure. However, it has some evidence to improve visual acuity in patients. Choline deficiency is likely not the true cause though, but something more upstream.
Vinpocetine has weak support as a treatment, it's been tried as an adjuvant once or twice. Worth a try perhaps.

Gingko has quite weak science behind it if any, so it's kind of a wash. Remember about publication bias - refutations are unlikely to be published.
A few reviews, such as Mayo Clinic's, say the results are equivocal. Examine.com actually says (B quality) it's ineffective against intraocular pressure. Normal pressure glaucoma perhaps... who knows, too weak evidence either way. Increasing blood flow in healthy patients is not the same as treating glaucoma. In fact, it might be cross purposes.

Proanthocyanidins are better taken in the diet than as a supplement - eat more vegetables and fruits, in this order. There is too little science to say whether they're efficacious alone in glaucoma - studies you cited are quite weak. What they might do is reduce the risk for having glaucoma in the first place and not be curative.
Melatonin indeed has no real evidence and it's not suitable for a supplement - unless you want to get to sleep quickly or make a special timed release formulation.
Picamilon study is also bad, no true control group.

Edited by AstralStorm, 16 November 2013 - 03:34 PM.

[Dizzon]

Thanks for your 2 cents, however your opinion on Ginko particularly is a bit pessimistic and perhaps incorrect. Consistent improvements in visual field tests (which my 60 y.o. mother has personally experienced, independently confirmed by her ophthalmologist, currently has 20/20 vision using only Ginko for glaucoma supplementation), therapeutic potential beyond effects on IOP, lots of human testing and established safety, and a dirt cheap price makes Ginko well worth the supplementation if one has Glaucoma. Perhaps you'd feel differently If you were in my real-life situation? For example ginko causes "improvement of central and peripheral blood flow, reduction of vasospasm, reduction of serum viscosity, antioxidant activity, platelet activating factor inhibitory activity, inhibition of apoptosis, and inhibition of excitotoxicity". Not something worth arguing about, but for people with glaucoma that have the $5/month to spare, Its definitely a worthy supplement and not as much of 'a wash' as you're implying. Same goes for Vinpocetine.

I agree with your opinion that the evidence behind picamilon, proanthocyanidins and melatonin are too elementary to seriously suggest them as a supplements to mitigate the damages of Glaucoma. I was merely attempting to find ALL supplements that could POTENTIALLY help slow the progression of Glaucoma. Are you aware of any supplements that I might have left out (aside from Emoxypine)? Even if their evidence is as rudimentary as the picamilon/proanthocyanids/melatonin evidence.

Edited by Dizzon, 16 November 2013 - 04:54 PM.

[blood]

Forskolin + rutin (two human studies)
http://www.ncbi.nlm....pubmed/22731245
http://www.ncbi.nlm....pubmed/20589347

Edited by blood, 17 November 2013 - 12:57 AM.

[niner]

Pycnogenol didn't have any noticeable effect on my high IOP (not quite glaucoma), although there are other things that I like about pycnogenol. I eventually got a laser iridotomy. Ginkgo is not without its problems. I can't use it without my blood pressure going up significantly.

[tham]

The causes of glaucoma, while complex, more likely stems from
a microcirculation insufficiency problem.

The arterioles to the eyes are tiny, so it doesn't take much to clog them up.


" .... glaucoma is instead caused by a deficiency of of oxygen and blood flow
..... the result of insufficient blood flow due to agglutination (clumping together)
of the red blood cells and waste buildup in the cells and intercellular fluids. "

" These blood-corpuscle clusters cannot squeeze through the extremely tiny
capillaries in the posterior of the eye, so cannot deliver oxygen to the mitochondria.
This is what the problem has been all along, and if people continue to eat soy and
canola oils, a lot more of them are going to experience vision irregularities - like
retinitis and macula lutea degeneration. "

" Death of the mitochondria in the cells in the posterior of the eye is due to oxygen
starvation, sodium toxicity and waste accumulation. When the mitochondria die, the
cells die and the posterior eye tissues atrophy. In this respect, glaucoma has much
in common with hair loss, Alzheimer's disease, multiple sclerosis, cerebral palsy
and hearing problems. "

http://www.shirleys-....com/canola.htm


Two which would help with microcirculation :

Vinpocetine
Tocopherol nicotinate


Effect of vasoactive drugs on visual functions and ocular
hemodynamics in patients with primary open-angle glaucoma.

'' Increased blood flow velocity in the ocular arteries after a course of
therapy with cavinton forte suggests a better retinal blood supply,
which is a favorable marker for the prediction of the disease. ''

http://www.ncbi.nlm....pubmed/19062562

Edited by tham, 18 November 2013 - 09:58 AM.

[tham]

Mirtogenol (bilberry extract + pycnogenol)
Erigeron breviscapus, Chinese herb (caffeic acid and scutellarin)
Carotenoids - lutein, zeaxanthin, astaxanthin
Marijuana
Vitamin C
Saffron
EGCG
Dark chocolate
Resveratrol
Pterostilbene
PQQ
Coenzyme Q10
Melatonin

Magnesium, as taurate
CDP choline, or citicholine
Fish oils
Cod liver oil
Alpha lipoic acid
Taurine
Curcumin
L-carnitine and Acetyl l-carnitine
Lycium barbarum (wolfberry)
Forskolin
Dan shen (Salvia miltiorrhiza)


Drugs :

Celecoxib
Hydergine
Nimodipine
Selegiline
Memantine
Rivastigmine
Galantamine (sold as supplement in the States)
Bis(7)-tacrine
Paracetamol

Edited by tham, 18 November 2013 - 10:51 AM.

[tham]

'' Although IOP is one of the main factors in glaucoma, many cases progress
despite the lowering of eye pressure to standard levels. In those cases, it is
necessary to find new and innovative ways to prevent or limit the damages other
than lowering the IOP. Since apoptosis plays a significant role in glaucoma,
investigations of compounds described as neuroprotectants may lead to promising
results. Numerous botanical compounds possess such neuroprotective properties,
which may be effective in the prevention and treatment of glaucoma. ''

http://www.hindawi.c...am/2013/549174/

[tham]

http://www.lef.org/p...s.htm#AnchorSug


http://www.vitaminwo...oma/supplements


http://www.optimumhe...84/Default.aspx




Visual field protective effect of Erigeron breviscapus (vant.) Hand. Mazz.
extract on glaucoma with controlled intraocular pressure: a randomized,
double-blind, clinical trial.

http://www.ncbi.nlm....pubmed/20698715



Effects of Mirtogenol on ocular blood flow and intraocular hypertension
in asymptomatic subjects.

http://www.ncbi.nlm....pubmed/18618008

http://www.mirtogenol.com



The synthetic cannabinoid WIN55212-2 decreases the intraocular pressure
in human glaucoma resistant to conventional therapies.

http://www.ncbi.nlm....pubmed/11168547



Endocannabinoids in the retina: from marijuana to neuroprotection.

http://www.ncbi.nlm....ubmed/18725316/



Therapeutic potential of cannabinoids in CNS disease.

http://www.ncbi.nlm....ubmed/12617697/




Idebenone prevents human optic nerve head astrocytes from oxidative stress,
apoptosis, and senescence by stabilizing BAX/Bcl-2 ratio.


'' ..... idebenone may help to protect ONHA (optic nerve head astrocytes) in vivo,
and therefore might be helpful in preventing the progression of glaucomatous
degeneration. ''


http://www.ncbi.nlm....ubmed/23661043/




Retinal damage caused by high intraocular pressure-induced
transient ischemia is prevented by coenzyme Q10 in rat.

http://www.ncbi.nlm....ubmed/17678974/






Neuroprotection with carotenoids in glaucoma.

'' Lutein and zeaxanthin, with its strong antioxidative effects, can
represent a viable solution in the complex treatment of glaucoma. ''

http://www.ncbi.nlm....ubmed/15083692/



Effects of blackcurrant anthocyanins on intraocular pressure
in healthy volunteers and patients with glaucoma.

http://www.ncbi.nlm....pubmed/23046438




Two-year randomized, placebo-controlled study of blackcurrant
anthocyanins on visual field in glaucoma.


http://www.ncbi.nlm....ubmed/22377796/




Cataract is a self-defence reaction to protect the retina from oxidative damage.

'' Extracting the opaque lens elevates the retinal oxidative stress and
increases the rate of age-related macular degeneration. ''


http://www.ncbi.nlm....pubmed/21354712

[tham]

Astaxanthin.



Suppressive effect of astaxanthin on retinal injury
induced by elevated intraocular pressure.

http://www.ncbi.nlm..../?term=20457203


Astaxanthin, a dietary carotenoid, protects retinal cells
against oxidative stress in-vitro and in mice in-vivo.

http://www.ncbi.nlm....ubmed/18812030/



The medical research of astaxanthin on eye health.

http://www.ncbi.nlm....ubmed/18812030/



Potential health-promoting effects of astaxanthin.

http://xa.yimg.com/k...eview+paper.pdf




'' Astaxanthin one of the most neuroprotective supplements yet discovered;
fat-soluble carotenoids protect the nervous system, brain and eyes. ''

http://www.naturalne...protection.html



'' Beyond Eye Health : How Astaxanthin Combats Degenerative Disease ''


http://www.lefeurope...agazines/118459




Intraocular pressure decreases in the Japanese with age.

http://www.ncbi.nlm..../pubmed/2194306

http://www.ncbi.nlm....pubmed/18039350



Primary open-angle glaucoma patients have reduced levels
of blood docosahexaenoic and eicosapentaenoic acids.

http://www.ncbi.nlm....pubmed/16410047



Dietary omega 3 fatty acids decrease intraocular pressure
with age by increasing aqueous outflow.

http://www.iovs.org/...g&pmid=17251475



Cod liver oil: a potential protective supplement for human glaucoma.

http://www.ncbi.nlm....les/PMC3340802/

[blood]

I agree with your opinion that the evidence behind picamilon, proanthocyanidins and melatonin are too elementary to seriously suggest them as a supplements to mitigate the damages of Glaucoma.

It was shown that melatonin delayed progression of macular degeneration in human subjects back in 2005 (small pilot study) - there doesn't appear to have been another clinical trial on meltaonin+macular degeneration since...! Waiting for clinical studies on melatonin+glaucoma seems possibly not a good strategy. You could be waiting forever. Given that melatonin is inexpensive & at worst harmless, why wouldn't you take it if there is even a slight chance of a beneficial effect?

http://www.ncbi.nlm....pubmed/16399908

Ann N Y Acad Sci. 2005 Dec;1057:384-92.

Effects of melatonin in age-related macular degeneration.

Yi C, Pan X, Yan H, Guo M, Pierpaoli W.

Source
Department of Fundus Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 510060 Guangzhou, China. yichang@public.guangzhou.gd.cn

Abstract

Age-related macular degeneration (AMD) is the leading cause of severe visual loss in aged people. Melatonin has been shown to have the capacity to control eye pigmentation and thereby regulate the amount of light reaching the photoreceptors, to scavenge hydroxyradicals and to protect retinal pigment epithelium (RPE) cells from oxidative damage. Therefore, it is reasonable to think that the physiological decrease of melatonin in aged people may be an important factor in RPE dysfunction, which is a well known cause for initiation of AMD. Our purpose is to explore a new approach to prevent or treat AMD. We began case control study with a follow-up of 6 to 24 months. One hundred patients with AMD were diagnosed and 3 mg melatonin was given orally each night at bedtime for at least 3 months. Both dry and wet forms of AMD were included. Fifty-five patients were followed for more than 6 months. At 6 months of treatment, the visual acuity had been kept stable in general. Though the follow up time is not long, this result is already better than the otherwise estimated natural course.1,2 The change of the fundus picture was remarkable. Only 8 eyes showed more retinal bleeding and 6 eyes more retinal exudates. The majority had reduced pathologic macular changes. We conclude that the daily use of 3 mg melatonin seems to protect the retina and to delay macular degeneration. No significant side effects were observed.

PMID: 16399908 [PubMed - indexed for MEDLINE]

Edited by blood, 24 November 2013 - 10:33 AM.

[albedo]

Bumping this up. Maybe this article could also be useful:

 

Nutrient Intervention for GLAUCOMA

http://www.lifeexten...laucoma/page-01