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Small Study Shows Potential Neuroprotective Effect of Combination Supplement in Glaucoma

Robert Ritch, MD
Robert Ritch, MD

In a small study, a combination over-the-counter supplement with antioxidant and mitoprotective properties significantly reversed mitochondrial dysfunction.

A supplement with antioxidant and mitoprotective properties reversed mitochondrial dysfunction and may be neuroprotective in glaucoma, according to study results presented by Robert Ritch, MD (Steven and Shelley Einhorn Distinguished Chair and Professor of Ophthalmology at New York Eye and Ear Infirmary of Mount Sinai, New York).

Dr. Ritch and co-investigators from Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, and Columbia University, New York, presented a poster with their findings at the American Glaucoma Society meeting in New York earlier this year.

The study focused on whether a combination of over-the-counter supplements with antioxidant and mitoprotective properties could reverse mitochondrial dysfunction by reducing mitochondrial flavoprotein fluorescence compared with placebo.

A total of 14 patients (n = 28 eyes) were divided into either a placebo group or a group that received a combination of curcumin, Ginkgo biloba extract, citicoline, coenzyme-Q10 (upiquinol, Cognizin), N-acetyl-cysteine, alpha-lipoic acid, grapeseed extract, and green tea extract. All of the aforementioned are part of a supplement called GlaucoHealth.

The study was performed as part of an investigational new drug application from the FDA.

Visual fields, optical coherence tomography (OCT), and retinal metabolic analysis were performed at baseline and at 1 and 3 months after randomization.

Researchers monitored for changes in visual fields, OCT, and retinal metabolic analysis over time. The initial demographic characteristics of the two groups were similar.

There were no significant differences in visual field or OCT indices in either group (all p > 5%).

However, there was a significant decrease in optic nerve adjusted mitochondrial flavoprotein fluorescence and average curve width from baseline to 1 month in those treated with GlaucoHealth (` = -39, p = 0.003; ` = -0.25, p = 0.01, respectively) but not in patients who were treated with placebo (p = 0.47 and 0.23).

“Mitochondrial dysfunction and death are increasingly implicated in retinal ganglion cell death in glaucoma and neuronal death in other neurodegenerative disorders,” Dr. Ritch said. “Mitochondria become dysfunctional and die prior to neuronal cell death.

“Formulations with IOP-dependent neuroprotective effects could be additive in slowing progression rates by reversing mitochondrial dysfunction,” he said.

Research such as that from this study could shift the treatment paradigm to stabilize mitochondria at an earlier disease stage, and prevent or retard neuronal cell death, the poster explained.

The findings “serve as a proof-of-concept for future trials testing the neuroprotective effect of supplement combinations in glaucoma,” according to the poster.

This article was adapted from a poster presentation at the 2018 meeting of the American Glaucoma Society in New York earlier this year. The authors did not indicate any proprietary interest relevant to the subject matter. Source: Ophthalmology Times (July 25, 2018)

Last reviewed on August 23, 2018

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