Glaucoma Update

I recently attended The Bascom Palmer’s Eye Institute International meeting in Miami, FL on January 26, 2013 called Glaucoma 2.0: Bench to Bedside

International speakers presented the latest preclinical trails and studies on new advances in the treatment of glaucoma.

Key points from this meeting  I would like to share with you.

  1. There has been no significant advance in the treatment of glaucoma since 1996 when the Xalatan (Latanoprost), a prostaglandin analogue was introduced.
  2. There are no eye drops that stop the progression of glaucoma, all studies have shown they just slow the visual loss.
  3. A glaucoma researcher, who has glaucoma, made the comment that if he had known he was going to lose vision he would have done everything possible to preserve his vision.
  4. Neuro-protection and regeneration of dysfunctional axons and ganglion cells were the focus of the conference.

Highlights of the conference that can help you now!

  • Sleep Apnea and Glaucoma by Dr. Hanna Kim

Patients with unexplained visual loss while under glaucoma management should be evaluated for sleep apnea. Low oxygen tensions at night, during sleep apnea might be a contributing factor to visual loss (Dr. Kondrot’s comments: Nocturnal Pulse oximetry can be done at home without going to a sleep apnea clinic to detect low levels of oxygen saturation)

  • Could Hyperbaric Oxygen Help? by Dr. Magaly A. Rodriguez

She reviewed several clinical studies and some glaucoma cases at her clinic that benefited from Hyperbaric Oxygen. (Dr. Kondrot’s Comments: EWOT (Exercise with oxygen therapy)  is method to gain the benefits of hyperbaric oxygen therapy while exercising at home with a 10 liter flow oxygen tank)

  • Effect of Citicoline on Glaucomatous Visual Function by Dr. Vincenzo M Parisi (Italy)

In the US, citicoline is marketed as a dietary supplement. Citicoline seems to increase a brain chemical called phosphatidylcholine, which is important for  brain function. Citicoline might also decrease brain tissue damage when the brain is injured. This study reported that citicoline significantly improves retinal and cortical responses in glaucoma patients, indicating a potential use of this substance in the medical treatment of glaucoma, as a complement to pressure lowering eye drops. (Dr Kondrot’s Comments:  This is fantastic! An approved food supplement that can improve retinal and cortical  function! I have used intravenous phosphatidylcholine to help patients with severe optic nerve damage but to increase phosphatidylcholine with a food supplement is something I am going to suggest to all my glaucoma patients. Suggest 200 to 600 mg  of Citicoline in divided dosages a day)

  • Treating Optic Neuropathy with Non-Invasive Alternating Current Stimulation by Dr. Bernhard A. Sabel (Germany)

Non invasive electrical stimulation is known to to induce cortical plasticity in normal subjects. Non-invasive, repetitive  transorbital alternative current stimulation (rtACS) was shown to  improve visual functions in patients with optic nerve damage.(Dr. Kondrot’s Comments: I have been using low levels of current for the last 15 years to help patients with glaucoma to improve visual function)

To Your Health and Good Vision
Dr. Edward Kondrot

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