In the news: Ocular Blood Flow and Glaucoma; Evidence-Based CAM Strategies

Lower Ocular Blood Flow May Help Predict Glaucoma Progression

The cornerstone of treatment for people with open-angle Glaucoma is maintaining a lower fluid pressure inside the eye, called intra-ocular pressure (IOP). It’s important because untreated high IOP can damage the optic nerve.

However, while lowering elevated IOP is crucial, it has been found that glaucoma can progress in some patients despite having well-controlled IOP. One factor that may contribute to this progression is impaired ocular blood flow. Ocular blood flow functions to bring needed oxygen and nutrients to the eye.

What has been missing, however, are long-term studies looking at whether ocular blood flow (reflected by bio- markers) may actually predict progression of the disease. In a recently published study(1) a team of US and Italian researchers provide more insight into the predictive value of blood flow in the eye.

The researchers evaluated 112 patients with early to moderate glaucoma at the beginning of the study and every 6 months over a 5-year period. They looked at capillary blood as well as functional and structural changes to the eye.

The results showed that lower retinal capillary blood flow in the superior retina (the top portion of the retina) was significantly linked to structural progression in glaucoma such as thinning of the retinal nerve fiber layer.

Research is continuing in hopes of better understanding how to protect the optic nerve and retinal cells from the effects of poor ocular blood flow and other potentially damaging factors such as oxidative stress.

Support for Some ‘Natural Pharmacy” Ingredients & Strategies

News that the US Food and Drug Administration declared that Phenylephrine – a common ingredient in over-the-counter cold, allergy and hay fever medications – is no better than placebo at relieving congestion, has prompted a new look at potential alternatives.

Some natural ingredients have proven to be effective remedies over the years. Honey, for example. There is increasing evidence that a single dose of honey might reduce mucus secretion and reduce cough in children.

While the evidence isn’t always from long and large clinical trials, when it comes to relieving congestion several ingredients or strategies come to mind that might be worth a try. Keep in mind that it’s always a good idea to run any new supplement or regimen by your physician to make sure it is right for you.

If congestion is due to hay fever, two herbal possibilities arise. One is butterbur leaf extract, which small studies suggest may be helpful in allergic rhinitis (hay fever) at doses standardized to 8 mg petasin – usually 50-150 mg of extract daily. One word of caution: Since butterbur contains toxic pyrrolizidine alkaloids (PA), be sure that the herbal product is labeled PA-free.

Results of a 2016 trial(2) indicate that turmeric, a common Asian spice containing curcumin, might be another botanical of interest for those with hay fever. That 2-month long study reported that 500 mg turmeric daily reduced nasal symptoms including congestion and improved air flow in those with allergic rhinitis.

Finally, for congestion due to both allergy and cold or flu, nasal Irrigation can be an effective strategy. It can flush out mucous and allergens, and for those who fight sinus infections, it may calm symptoms and reduce antibiotic use. The cautionary note here is use distilled or sterile water, or water that’s been boiled 3-5 minutes and cooled.

References

1. Vercellin AC Harris A, et al. Ocular blood flow bio-Markers may predict long-term glaucoma progression. BJO [Epub ahead of print] Oct, 18, 2023.
2. Wu S, et al. Effect of curcumin on nasal symptoms and airflow in patients with perennial allergic rhinitis. Ann Allergy Asthma Immunol. 117:697-702, 2016.