Abstract
Background Glaucoma is a multifactorial optic neuropathy, which causes a continuous loss of retinal ganglion cells. Given the neurodegenerative nature of glaucoma, the necessity for neuroprotective intervention still arises, to be added alongside hypotonic therapy. Objective The objective of this study was to assess the effect of daily intake of a homotaurine, carnosine, forskolin, vitamins B1, B2, and B6, folic acid, and magnesium based supplement (GANGLIOLIFE®) on the progression rates of the visual field in patients with progressive POAG despite good tonometric compensation and to assess the most suitable dosage. Methods This is a monocentric nonrandomized experimental clinical study. Patients with mean deviation (MD) ranging from −2 dB to −15 dB with MD progression ≥1 dB in the previous year and IOP values of ≤18 mm Hg were included. All the patients underwent supplement therapy for a period of 6 months. For the first 2 months, they took 2 tablets a day, and for the following 4 months, 1 tablet a day. The patients were assessed before the start of treatment, time 0 (T0), after 2 months (T1), and after 6 months (T2) of therapy. At each check-up, patients were given a full eye test including perimetry, RNFL, and GCC using FD-OCT, PERG, contrast sensitivity, and QoL evaluation using the Glaucoma Symptom Scale questionnaire and National Eye Institute Visual Function Questionnaire 25. Results 31 patients with a mean age of 70.80 ± 8.77 were included. At T1 and T2, the mean values of MD were lessened (MD = −5.37 ± −2.91, P < 0.01, and MD = −5.48 ± 3.15, P < 0.05, respectively) compared to T0 (MD = -5.98 ± 2.83). Patients also demonstrated a significant reduction in IOP (P < 0.01), improved light sensitivity (P < 0.01) and contrast sensitivity (P < 0.05), and a better quality of life (P < 0.05). Conclusions Treatment with a supplement which includes homotaurine, carnosine, forskolin, vitamins B1, B2, and B6, folic acid, and magnesium has been shown to be able to slow down the rate of progression of functional damage and improve visual function after 2 and 6 months of daily intake. Quality of life showed significant improvement.
Highlights
Glaucoma is a multifactorial optic neuropathy leading to a continuous loss of retinal ganglion cells [1, 2]. e loss of the visual field in glaucoma is the direct consequence of the loss of retinal nerve fibres, which have a specific anatomical arrangement in the retina: the nerve fibres of the temporal retina do not cross the horizontal median line and, the scotomas follow the shape of these bands of fibres, giving rise to defects in the visual field characteristic of glaucoma [3, 4]
Recent discoveries have led to a new perception of glaucomatous pathology: the term Glaucoma 2.0 [2] refers to the recent attention paid to neuronal damage and to the neurodegenerative nature of the disease, which has provided the foundation for a new generation of therapeutic targets
As further proof of its neurodegenerative nature, primary open-angle glaucoma presents important analogies with other neurodegenerative diseases: it has been Journal of Ophthalmology shown that retinal ganglion cells (RCG) have cell death mechanisms similar to those of Alzheimer’s disease (AD), primarily represented by apoptosis
Summary
Glaucoma is a multifactorial optic neuropathy, which causes a continuous loss of retinal ganglion cells. Given the neurodegenerative nature of glaucoma, the necessity for neuroprotective intervention still arises, to be added alongside hypotonic therapy. E objective of this study was to assess the effect of daily intake of a homotaurine, carnosine, forskolin,. ® vitamins B1, B2, and B6, folic acid, and magnesium based supplement (GANGLIOLIFE ) on the progression rates of the visual field in patients with progressive POAG despite good tonometric compensation and to assess the most suitable dosage. All the patients underwent supplement therapy for a period of 6 months. E patients were assessed before the start of treatment, time 0 (T0), after 2 months (T1), and after 6 months (T2) of therapy. At each check-up, patients were given a full eye test including perimetry, RNFL, and GCC using FD-OCT, PERG, contrast sensitivity, and QoL evaluation using the Glaucoma Symptom Scale questionnaire and National Eye Institute Visual Function Questionnaire
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