Dr. Grossman’s Blog

According to an article published in The Journal of Pineal Research, evidence from a number of sources supports the assertion that increased free radical generation and altered nitric oxide (NO) metabolism contribute to glaucoma and uveitis. Data indicates that melatonin is an efficient antioxidant that has the ability to fight free radicals and break down nitric oxide and plays ” a promising role in the treatment of these ocular dysfunctions.”  Melatonin has few side effects even at high doses and can potentially do a great deal to protect ocular tissue.

For more on vision wellness, visit us at NaturalEyeCare.com.

Source information: http://www3.interscience.wiley.com/journal/123439574/abstract?CRETRY=1&SRETRY=0

Researchers at the University of Alabama at Birmingham believe that thyroid disorders may increase the risk of glaucoma.  Their study, published in the British Journal of Ophthalmology, reviewed data from the 2002 National Health Interview Survey to quantify the association between a self-reported diagnosis of glaucoma and a self-reported history of thyroid problems.

Of the 12,376 survey participants, 4.6% reported glaucoma, and 11.9% reported a history of thyroid problems.  The prevalence of glaucoma among those who reported thyroid problems was 6.5% compared with 4.4% among those who did not report thyroid problems.  This association between glaucoma and thyroid problems remained after adjusting for differences in age, gender, race and smoking status.

The results of this study lend support to the hypothesis that thyroid disorders may increase the risk of glaucoma.   Although further research on the topic is expected, study authors suspect that hypothyroidism may diminish outflow in the eye.

Learn more about glaucoma, including prevention and treatment options at the Natural Eye Care website

SOURCE:  The association between thyroid problems and glaucoma, Cross, et al, British Journal of Ophthalmology 2008;92:1503-1505.

Although open-angle glaucoma (OAG) has been previously associated with some of the risk factors of stroke development, researchers at the Taipei Medical University in Taipei, Taiwan have now linked OAG with an increased risk of stroke development.

Researchers collected data from the 1,073,891 subjects in the Taiwan National Health Insurance Research Database.  They compared 4032 patients with a diagnosis of OAG to 20,160 patients without OAG over a five year period.

Of the group of patients with OAG, 14.9% had strokes within the 5-year follow-up period, compared with 9.5% of patients in the comparison group.   After adjusting for patients’ demographic characteristics, patients with OAG were found to have a 1.52-fold higher risk of having a stroke than the matched comparison cohort.

Study authors concluded that patients with OAG demonstrated a significantly increased risk of stroke development during the 5-year follow-up period.

Learn more about glaucoma including self-help tips

Read other studies about glaucoma

SOURCE:  “Open-Angle Glaucoma and the Risk of Stroke Development. A 5-Year Population-Based Follow-Up Study”, Ho, et al, PubMed, 2009 May 21, http://www.ncbi.nlm.nih.gov/pubmed/19461039

Researchers tie blood pressure and ocular perfusion pressure to glaucoma

Although intraocular pressure (IOP) is considered a primary risk factor for the development of glaucoma, there is evidence to suggest that glaucoma may continue to progress despite lowering patients’ IOP to targeted levels.

Several recent studies point to vascular risk factors in the development of glaucoma. This new research indicates that blood pressure (BP) and ocular perfusion pressure have become increasingly important in understanding and treating glaucoma.

Although doctors cannot currently visualize ocular blood flow directly, they can easily measure glaucoma patients’ BP and IOP to calculate their ocular perfusion pressure and quantify the vascular changes.

An article published in the British Journal of Ophthalmology explores the relationships between BP and IOP, BP and glaucoma, and perfusion pressure and glaucoma. Study authors suggest that ocular perfusion pressure and its fluctuation may be parameters that need to be measured in the treatment of glaucoma patients.

Learn more about glaucoma, including self-help tips

SOURCE: Blood Pressure and Glaucoma, Costa, et al, Br J Ophthalmol, 30 March 2009, doi:10.1136/bjo.2008.149047.

In glaucoma, cells in the optic nerve die, preventing the brain from understanding what patients see.

Scientists have long believed that there is a link between a gene named WDR36 and glaucoma, but have been unable to determine what the gene does and why some people with variations of the gene get glaucoma while others don’t.

University of Alberta geneticist, Dr. Michael Walter, has published results of a new study which help to explain this link. 

“Our results suggest that glaucoma is polygenetic, which means there have to be changes in several different genes in order for WDR36 to cause the disease,” said Walter, a professor and chair of the Department of Medical Genetics in the Faculty of Medicine & Dentistry.  This finding helps explain why only some people who have WDR36 gene variations get glaucoma.

“Only 10 per cent of glaucoma cases are caused by known genes, so the genes involved in this polygenetic interaction may help to explain the other 90 per cent,” said Walter, who is also a professor in the Department of Ophthalmology.

The WDR36 gene normally helps make ribosomes, specialized molecules that make the proteins necessary to keep the cell functioning.  Dr. Walter suspects that changes to WDR36 will affect ribosome production, and in turn affect the cell’s ability to function.

In addition to this mutation, changes also have to happen to the STI1 gene, which normally packages the proteins produced by WDR36′s ribosomes.  Glaucoma occurs when WDR36 isn’t producing ribosomes properly and STI1 isn’t packaging those proteins properly.  Both mutations must be present to cause the disease.

This DNA detective work may have a tangible impact on preventing and treating glaucoma, as it may help doctors learn to treat the disease rather than just the symptoms.

Learn more about glaucoma

SOURCE:  “Genetic Sleuth Solves Glaucoma Mystery”, University of Alberta Express News, March 20, 2009, http://www.expressnews.ualberta.ca/article.cfm?id=10052.

At the American Glaucoma Society meeting, Dr. JoAnn A. Giaconi reported that women who reported eating greater amounts of fruits and vegetables appeared to have a lower likelihood of developing glaucoma.

The foods that seemed especially protective included fresh oranges, peaches, spinach, collard greens, and kale.

Dr. Giaconi presented results from a review of data from the Study of Osteoporotic Fractures.  In this study involving a subset of 584 black women, glaucoma was diagnosed in at least one eye in 77 participants.  Disc photos and suprathreshold visual fields were evaluated in conjunction with Block Food Frequency Questionnaires on the participants’daily food consumption.

The results?

• Eating three or more servings of fruit or fruit juices daily decreased the odds of black women developing glaucoma by 79%
• Eating one serving of collard greens or kale decreased the odds of glaucoma by 57%
• Eating more than two servings per week of fresh oranges and peaches also significantly decreased the chance of developing glaucoma.

Researchers believe that the antioxidants in fruits and vegetables (vitamin A, alpha- and beta-carotene, folate, lutein, zeaxanthin) can potentially block oxidation stress that can lead to cell damage in glaucoma.

Read other studies about the benefits of consuming antioxidants

SOURCE:  Giaconi JA, et al. Nutritional associations with glaucoma among older black women. Paper presented at: The 18th Annual AGS Meeting; March 8, 2008; Washington, DC.

Researchers at the Department of Ophthalmology and Jules Stein Eye Institute, University of California-Los Angeles, recently studied the association between consumption of fruits and vegetables and the presence of glaucoma.

1,155 women located in multiple centers in the United States participated in this cross-sectional cohort study. Glaucoma specialists evaluated the women for glaucoma; consumption of fruits and vegetables was assessed using a food frequency questionnaire.

Among the 1,155 women studied, 95 (8.2%) were diagnosed with glaucoma. Analysis of the relationship between selected fruit and vegetable consumption and glaucoma showed:

• Glaucoma risk was decreased 69 percent in women who consumed at least one serving per month of green collards and kale compared with those who consumed fewer than one serving per month.
•  Glaucoma risk was decreased 64 percent in women who consumed more than two servings per week of carrots compared with those who consumed fewer than one serving per week.
• Glaucoma risk was decreased 47 percent in women who consumed at least one serving per week of canned or dried peaches compared with those who consumed fewer than one serving per month.

Although researchers note that more studies are needed to investigate the relationship between nutrition and glaucoma, research to date does indicate that a higher intake of certain fruits and vegetables may be associated with a decreased risk of glaucoma.

Learn more about glaucoma

Read other studies about nutrition and glaucoma

SOURCE: “Glaucoma risk and the consumption of fruits and vegetables among older women in the study of osteoporotic fractures”, Coleman, et al, Am J Ophthalmol. 2008 Jun;145(6):1081-9.

The findings provide hope for treating blindness caused by optic-nerve damage, but
also look promising for spurring similar regeneration in the spinal cord and brain.
Researchers said Monday a newly discovered growth factor could hold the key to regenerating damaged optic nerves — and more. The research team at Children’s Hospital in Boston say they have found a naturally occurring, previously unrecognized growth factor that stimulates regeneration in injured optic nerves.
The findings provide hope for treating blindness caused by optic-nerve damage, but
also look promising for spurring similar regeneration in the spinal cord and brain,
they said.

The growth factor is called oncomodulin and when it was added to retinal nerve cells
in the lab, with known growth-promoting factors already present, the growth of axons
– or cells in the optic nerves — nearly doubled.

No other growth factor was as potent, the researchers said.

More Nerve Regeneration

In live rats with optic-nerve injury, oncomodulin released from tiny sustained-release
capsules increased nerve regeneration five- to seven-fold when given along with
a drug that helps cells respond to oncomodulin, the team said.

Oncomodulin also appears to switch on a variety of genes associated with axon growth,
the researchers said.

“Out of the blue, we found a molecule that causes more nerve regeneration than
anything else ever studied,” said one of the study investigators. We expect
this to spur further research into what else oncomodulin is doing in the nervous
system and elsewhere.

The data are published in the May 14 online edition of Nature Neuroscience.

For more related research, go to www.naturaleyecare.com (see “Research” section).

A study by Alcon Research Ltd. and the University of Iowa suggests that increased expression of the protein sFRP-1, an inhibitor of cell signaling through WNT proteins, may be responsible for elevated IOP in individuals with glaucoma.

Glaucoma is a major cause of visual impairment and blindness throughout the world. An important risk factor for the disease is an increase in the intraocular pressure (IOP). IOP, the fluid pressure in the eye, is determined by the rate of production of the clear fluid in the eye and the rate at which this fluid flows out of the eye. Although it is thought that impaired outflow of fluid from the eye causes the increased IOP in individuals with glaucoma, the exact molecular mechanisms of the disease are not fully understood.

Researchers found increased expression of sFRP-1 in eye tissue from patients with glaucoma; when they treated donor human eyes with sFRP-1 ex vivo, these eye tissues had less outflow of fluids compared to untreated eyes. The sFRP-1-treated donor eyes also had reduced expression of a WNT-related protein.

To further support this relationship, mice manipulated to express sFRP-1 in the eye displayed increased IOP. When a downstream suppressor of WNT signaling was inhibited, the problem was resolved.

The authors believe that restoring WNT signaling might provide a new method for treating patients with glaucoma in the future.

Read more about glaucoma, including information on lifestyle choices and nutrition for maintaining healthy vision.

SOURCE: “Increased expression of the WNT antagonist sFRP-1 in glaucoma elevates intraocular pressure”, Wang, et al, Journal of Clinical Investigation, 118(3): 1056-1064 (2008).

The Glaucoma Research Foundation (GRF) has received a gift of $1,550,000 from Melza and F.T. Barr, a GRF board member from Houston, to fund its new $12 million capital campaign in support of a comprehensive new strategic plan. The new capital campaign builds on the momentum of a three-year campaign completed in the summer of 2007, in which the goal of $7.5 million was met and exceeded. That campaign was originally motivated by the need to extend GRF’s Catalyst For a Cure research consortium into a second three-year cycle after its startup phase. Among the top objectives in the new strategic plan are the goal to reinforce GRF’s commitment to innovative research, emphasizing the need for the multi-year collaborations aimed at funding a cure; to seek partnerships with affiliate agencies to maximize patient resources and minimize duplication of efforts and offer wide distribution of these materials at minimal cost to eyecare professionals and their patients; and to continue the financial efficiency level that allows GRF to devote 85 cents of every dollar raised to research and patient education. For more information on the GRF, go to www.glaucoma.org. Also see our discussion of Glaucoma Treatment Options.